TachycardiaPhase 1/2NCT00262470
Treatment of Orthostatic Intolerance
A Phase 1/2 study testing Acetazolamide, Atomoxetine and NO Drug in people with Tachycardia and Chronic Orthostatic Intolerance, run by Satish R. Raj at 1 site in United States.
Trial summary
This trial is designed to study the effects of various mechanistically unique medications in controlling excessive increases in heart rate with standing and in improving the symptoms of orthostatic intolerance in patients with this disorder. Read more about this study
- Who is it for?
- Ages 18 to 70 yearsHealthy volunteers can take part
- Conditions the study is for
- Tachycardia, Chronic Orthostatic Intolerance
- What is being tested?
- Acetazolamide, Atomoxetine and NO Drug
- Type of treatment
- Pill or oral medicine, Injection or infusion, Medical device, Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 150 participants
- Where
- 1 siteUnited States
- Study dates
- Apr 1997to Dec 2029
- Phase
- Phase 1/2
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Chronic symptoms (> 6 months) with standing upright
Who cannot join
- Obvious cause of hypovolemia or drugs that could worsen tachycardia
- Chronic severe medical conditions such as cancer or ischemic heart disease
Trial locations and contacts
1 site in 1 country.
United States1 site
Vanderbilt University Autonomic Dysfunction Center
Nashville, Tennessee, 37232-2195
About this study
This trial is designed to study the effects of various mechanistically unique medications in controlling excessive increases in heart rate with standing and in improving the symptoms of orthostatic intolerance in patients with this disorder.
Read the detailed description
This trial is designed to study the effects of various mechanistically unique medications in controlling excessive increases in heart rate with standing and in improving the symptoms of orthostatic intolerance in patients with this disorder.
Pilot drug trials are 4h in duration from ~9am -1pm. Different short-acting medications will be used to determine their acute hemodynamic effects in patients with orthostatic intolerance.
- Conditions
- Tachycardia, Chronic Orthostatic Intolerance
- Being tested
- Acetazolamide, Atomoxetine, NO Drug, Clonidine, Entacapone
- Keywords
- tachycardia, sinus tachycardia, postural tachycardia syndrome (POTS)
- Medical subject headings
- Tachycardia, Tachycardia, Sinus, Postural Orthostatic Tachycardia Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AcetazolamideDrug
Also called Diamox
250 mg PO x 1
AtomoxetineDrug
Also called Strattera
10-40 mg PO x 1 dose
NO DrugOther
No intervention - just monitoring
ClonidineDrug
Also called Catapres
Clonidine 0.05-0.3 mg PO x 1 dose
EntacaponeDrug
Also called Comtan
Entacapone 200-400 mg PO x 1 dose
Entacapone & PropranololDrug
Also called Comtan, Inderal
Entacapone 200-400 mg PO x 1 dose AND propranolol 20 mg PO x 1 dose
Atomoxetine & PropranololDrug
Also called Strattera, Inderal
Atomoxetine 10-40 mg PO x 1 dose AND propranolol 20 mg PO x 1 dose
IndomethacinDrug
Also called Indocin
Indomethacin 25-50 mg PO x 1 dose
MecamylamineDrug
Also called inversine
mecamylamine 1.25-5 mg PO x 1 dose
Isosorbide DinitrateDrug
Also called Isordil
Isosorbide dinitrate 5-20 mg PO x 1 dose
MelatoninDietary supplement
melatonin 3 mg PO x 1 dose
MidodrineDrug
Also called pro-amatine
midodrine 2.5-10 mg PO x 1 dose
ModafinilDrug
Also called provigil
modafinil 100-200 mg PO x 1 dose
OctreotideDrug
Also called sandostatin
octreotide 12.5-50 mcg Subcutaneous x 1 dose
PlaceboRadiation
lactose tablet x 1 pill
PropranololDrug
Also called Inderal
Propranolol 10-80 mg PO x 1-2 dose
Modafinil & PropranololDrug
Also called Provigil, Inderal
Modafinil 100-200 mg PO x 1 dose AND Propranolol 20 mg PO x 1 dose
SertralineDrug
Also called Zoloft
sertraline 25-50 mg PO x 1 dose
IV SalineProcedure or surgery
Also called NaCl solution (0.9%)
1 liter IV over 2 hours
Drinking WaterOther
16 fluid ounces
Breathing DeviceDevice
Breathing through a dead space tube
memantineDrug
Also called Namenda
memantine 5-20 mg PO x 1 dose
Abdominal binderDevice
Using large blood pressure cuffs linked together, they are wrapped around the subjects abdomen and inflated to generate increased pressure to below tolerably threshold.
| Study group | Role | What they receive |
|---|---|---|
| 1 | Experimental | Acetazolamide Receives: Drug: Acetazolamide |
| 2 | Experimental | Atomoxetine Receives: Drug: Atomoxetine; Drug: Atomoxetine & Propranolol |
| 3 | Experimental | NO Drug Receives: Other: NO Drug |
| 4 | Experimental | Clonidine Receives: Drug: Clonidine |
| 5 | Experimental | Entacapone Receives: Drug: Entacapone; Drug: Entacapone & Propranolol |
| 6 | Experimental | Indomethacin Receives: Drug: Indomethacin |
| 7 | Experimental | Isosorbide Dinitrate Receives: Drug: Isosorbide Dinitrate |
| 8 | Experimental | Mecamylamine Receives: Drug: Mecamylamine |
| 9 | Experimental | Memantine Receives: Drug: memantine |
| 10 | Experimental | Melatonin Receives: Dietary Supplement: Melatonin |
| 11 | Experimental | Midodrine Receives: Drug: Midodrine |
| 12 | Experimental | Modafinil Receives: Drug: Modafinil; Drug: Modafinil & Propranolol |
| 13 | Experimental | Octreotide Receives: Drug: Octreotide |
| 14 | Placebo comparator | Placebo (lactose tablet) Receives: Radiation: Placebo |
| 15 | Experimental | Propranolol Receives: Drug: Entacapone & Propranolol; Drug: Atomoxetine & Propranolol; Drug: Propranolol; Drug: Modafinil & Propranolol |
| 16 | Experimental | Sertraline Receives: Drug: Sertraline |
| 17 | Experimental | Normal Saline (0.9%) 1 liter Receives: Procedure: IV Saline |
| 18 | Experimental | Drinking Water Receives: Other: Drinking Water |
| 19 | Experimental | Dead Space Breathing Device Receives: Device: Breathing Device |
| Abdominal Binder | Experimental | Abdominal binder with inflatable pressure over abdomen Receives: Device: Abdominal binder |
What is being measured
The primary outcome is the main question the study is designed to answer.
Increase in heart rate with standing
Measured: 1-4 hours
Secondary outcomes (5)
Sitting heart rate
Measured: 1-4 hours
Standing heart rate
Measured: 1-4 hours
Blood pressure
Measured: 1-4 hours
Decrease in blood pressure with standing
Measured: 1-4 hours
Orthostatic symptoms score
Measured: Baseline, 2h, 4h
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Dec 2005 (estimated)
- Study startApr 1997
- Primary completionDec 2029 (estimated)
- Study completionDec 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for TachycardiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 150 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Satish R. Raj
- Sponsor type
- University, hospital or other
- Collaborators
- National Center for Advancing Translational Sciences (NCATS)
- Responsible party
- Sponsor-investigator, Satish R. Raj, Vanderbilt University
- Investigators
- Satish R Raj, MD MSCI, Principal investigator, Vanderbilt University School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00262470
- Sponsor's protocol ID
- 008397
- Other IDs
- UL1TR000445
- Status last verified
- Oct 2026
- First submitted
- 5 Dec 2005
- Last updated
- 16 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
Publications
Raj SR, Black BK, Biaggioni I, Harris PA, Robertson D. Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome. Circulation. 2005 May 31;111(21):2734-40. doi: 10.1161/CIRCULATIONAHA.104.497594. Epub 2005 May 23.
PubMed 15911704Raj SR, Black BK, Biaggioni I, Paranjape SY, Ramirez M, Dupont WD, Robertson D. Propranolol decreases tachycardia and improves symptoms in the postural tachycardia syndrome: less is more. Circulation. 2009 Sep 1;120(9):725-34. doi: 10.1161/CIRCULATIONAHA.108.846501. Epub 2009 Aug 17.
PubMed 19687359Smith EC, Diedrich A, Raj SR, Gamboa A, Shibao CA, Black BK, Peltier A, Paranjape SY, Biaggioni I, Okamoto LE. Splanchnic Venous Compression Enhances the Effects of ss-Blockade in the Treatment of Postural Tachycardia Syndrome. J Am Heart Assoc. 2020 Jul 21;9(14):e016196. doi: 10.1161/JAHA.120.016196. Epub 2020 Jul 16.
PubMed 32673517Nwazue VC, Paranjape SY, Black BK, Biaggioni I, Diedrich A, Dupont WD, Robertson D, Raj SR. Postural tachycardia syndrome and inappropriate sinus tachycardia: role of autonomic modulation and sinus node automaticity. J Am Heart Assoc. 2014 Apr 10;3(2):e000700. doi: 10.1161/JAHA.113.000700.
PubMed 24721800Nwazue VC, Arnold AC, Raj V, Black BK, Biaggioni I, Paranjape SY, Orozco C, Dupont WD, Robertson D, Raj SR. Understanding the placebo effect in clinical trials for postural tachycardia syndrome. Clin Exp Pharmacol Physiol. 2014 May;41(5):325-30. doi: 10.1111/1440-1681.12221.
PubMed 24606242Green EA, Black BK, Biaggioni I, Paranjape SY, Bagai K, Shibao C, Okoye MC, Dupont WD, Robertson D, Raj SR. Melatonin reduces tachycardia in postural tachycardia syndrome: a randomized, crossover trial. Cardiovasc Ther. 2014 Jun;32(3):105-12. doi: 10.1111/1755-5922.12067.
PubMed 24495468Mar PL, Raj V, Black BK, Biaggioni I, Shibao CA, Paranjape SY, Dupont WD, Robertson D, Raj SR. Acute hemodynamic effects of a selective serotonin reuptake inhibitor in postural tachycardia syndrome: a randomized, crossover trial. J Psychopharmacol. 2014 Feb;28(2):155-61. doi: 10.1177/0269881113512911. Epub 2013 Nov 13.
PubMed 24227635Green EA, Raj V, Shibao CA, Biaggioni I, Black BK, Dupont WD, Robertson D, Raj SR. Effects of norepinephrine reuptake inhibition on postural tachycardia syndrome. J Am Heart Assoc. 2013 Sep 3;2(5):e000395. doi: 10.1161/JAHA.113.000395.
PubMed 24002370