Recommendation ID

Orthostatic hypotension treatment:- For people with Parkinson's disease, what is the most effective pharmacological treatment for orthostatic hypotension?
Particular interventions and comparisons of interest are:
- midodrine compared with fludrocortisone (primary comparison)
- pyridostigmine
- ephedrine
- pseudoephedrine.

Any explanatory notes
(if applicable)

Why this is important:- The guideline committee felt that orthostatic hypotension was an important practical problem, common in people with Parkinson's disease and a contributor to falls and injuries. The current best pharmacological treatment is not yet established and research in this area would help to determine this. The randomised controlled trials that have previously been undertaken have only provided low-quality evidence (because of both small sample sizes and weaknesses in the trial designs) and cover only a subset of the comparisons of interest, making future research in this area of value.

Source guidance details

Comes from guidance
Parkinson’s disease in adults
Date issued
July 2017

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/07/2017