Q J Med 1995; 88: 719-725
© 1995 Association of Physicians
Octreotide reduces alcohol-induced hypotension and orthostatic symptoms in primary autonomic failure
Autonomic Unit, University Department of Neurology, Institute of Neurology, National Hospital for Neurology and Neurosurgery, and Cardiovascular Medicine Unit, Department of Medicine, St Mary's Hospital Medical School/Imperial College of Science, Technology and Medicine London, UK
Address correspondence to Dr K. Ray Chaudhuri, Department of Neurology, Institute of Psychiatry, De'Crespigny Park, Denmark Hill, London SE5 8AF
Received 16 March 1995 Accepted for publication 22 May 1995.
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Abstract |
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Symptomatic postural hypotension is a major problem in patients with primary idiopathic autonomic failure, and ingestion of small quantities of alcohol may worsen the degree of postural hypotension. The proposed mechanisms include mesenteric vasodilatation and release of vasodilatory gut peptides. We measured systemic, mesenteric, other regional vascular and biochemical responses to alcohol ingestion before and after pre-treatment with the somatostatin analogue Octreotide (which inhibits the release of a wide range of gut peptides normally released inresponse to food ingestion) in six patients with primary autonomic failure. Octreotide effectively prevented alcohol-induced hypotension and vasodilatation of the mesenteric vascular bed, with improvement of signs and symptoms of hypotension post-alcohol. This suggests that the mechanism of alcohol-induced symptomatic hypotension in autonomic failure is at least partly mediated by release of vasodilatatory gut peptides with resultant mesenteric vasodilatation.