Managing Orthostatic Hypotension (article for physicians)

This post may be of interest to those who would like some ideas on dealing with orthostatic hypotension.

An article was published in late October 2015 in a managed care journal for MDs on how to treat neurogenic orthostatic hypotension that occurs in MSA, LBD, and Parkinson’s.  It’s a short article, and is available at no charge online.

In particular, I like the list of non-pharmacologic physical “counter-maneuvers” that can be employed for orthostatic hypotension (OH).

Two websites are mentioned with video instructions and tutorials — and

On the last page, you can find a link for the PDF of the full article.  Looking at the PDF seems to be the only way to view the tables.  There are two good tables — a list of drugs that cause OH (copied below), and details on three medications for OH (droxidopa, midodrine, and fludrocortisone).


Table 2. Drugs That Cause Orthostatic Hypotension

Alpha1-adrenergic antagonists
doxazosin, prazosin, terazosin

Antipsychotic drugs
clozapine, quetiapine, iloperiodone, chlorpromazine, thioridazine

furosemide, hydrochlorothiazide

amitriptyline, clomipramine, imipramine, doxepin >6mg/day, trimipramine, trazodone

Calcium channel blockers
diltiazem, verapamil

Anti-Parkinson drugs
amantadine, levodopa, pramipexole, ropinirole, selegiline

Monoamine oxidase type A inhibitors
phenelzine, tranylcypromine

isosorbide dinitrate, nitroglycerin