Droxidopa / Pyridostigmine in Orthostatic Hypotension

NCT ID: NCT01370512

Last Updated: 2025-07-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Clinical Phase

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2026-05-31

Brief Summary

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This study is being done to study the combination of pyridostigmine and low-dose Droxidopa for the treatment of orthostatic hypotension.

Detailed Description

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Conditions

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Orthostatic Hypotension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Placebo-controlled, double-blind, randomized four-way crossover
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo, Then Pyridostigmine

participants first receive placebo by mouth 3 times a day, for treatment day 1. Then participants receive pyridostigmine by mouth 3 times a day for treatment day 2.

Group Type ACTIVE_COMPARATOR

Pyridostigmine

Intervention Type DRUG

60 mg tablets by mouth three times a day

Placebo

Intervention Type OTHER

Looks exactly like the study drug but contains no active ingredients

Pyridostigmine, Then Placebo

participants first receive pyridostigmine by mouth 3 times a day, for treatment day 1. Then participants receive placebo by mouth 3 times a day for treatment day 2.

Group Type ACTIVE_COMPARATOR

Pyridostigmine

Intervention Type DRUG

60 mg tablets by mouth three times a day

Placebo

Intervention Type OTHER

Looks exactly like the study drug but contains no active ingredients

Drioxidopa and Placebo, Then Drioxidopa and Pyridostigmine

participants first receive placebo by mouth 3 times a day, for treatment day 3. Then participants receive Droxidopa by mouth 3 times a day for treatment day 4.

Group Type EXPERIMENTAL

Droxidopa

Intervention Type DRUG

100 mg tablets by mouth three times a day

Pyridostigmine

Intervention Type DRUG

60 mg tablets by mouth three times a day

Placebo

Intervention Type OTHER

Looks exactly like the study drug but contains no active ingredients

Droxidopa and Pyridostigmine, Then Droxidopa and Placebo

participants first receive Droxidopa by mouth 3 times a day, for treatment day 3. Then participants receive Placebo by mouth 3 times a day for treatment day 4.

Group Type EXPERIMENTAL

Droxidopa

Intervention Type DRUG

100 mg tablets by mouth three times a day

Pyridostigmine

Intervention Type DRUG

60 mg tablets by mouth three times a day

Placebo

Intervention Type OTHER

Looks exactly like the study drug but contains no active ingredients

Interventions

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Droxidopa

100 mg tablets by mouth three times a day

Intervention Type DRUG

Pyridostigmine

60 mg tablets by mouth three times a day

Intervention Type DRUG

Placebo

Looks exactly like the study drug but contains no active ingredients

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. The presence of OH (fall in systolic BP \>=30 mm Hg) is required for this study.
2. Autonomic testing and clinical evaluation demonstrates OH to be of neurogenic etiology.

Exclusion Criteria

1. Pregnant or lactating females.
2. Chronic illnesses or the presence of other conditions that potentially involve the CNS or affect autonomic testing. These include congestive heart failure, recent (\<6 months) myocardial infarct, severe anemia, diabetes mellitus, alcoholism, malignant neoplasms, amyloidosis, hypothyroidism, sympathectomy, cerebrovascular accidents, and neurotoxins or neuroactive drug exposure.
3. Orthopedic problems or cardiopulmonary disease, sufficient to compromise mobility and activity of daily living.
4. Any known concurrent infection or severe liver or kidney disease.
5. Medications that could affect autonomic function are suspended prior to autonomic testing. Therapy with midodrine, alpha and beta adrenergic antagonists, or other medications that affect autonomic function will be withdrawn 48 hours prior to autonomic evaluations. Fludrocortisone doses up to 0.2 mg per day will be permitted. Stable doses of antidepressants (tricyclics, SSRIs, SNRIs) will also be permitted. The 48h medication withdrawal is reviewed on a case by case basis - if felt unsafe by the investigators, the withdrawal period may be shortened. This will be documented in the study documents.
6. Occasional use of a neuroleptic as an anti-emetic in the past is allowed, but none can have been used within 3 weeks prior to this study.
7. Use of methylphenidate, cinnarizine, reserpine, amphetamine, atypical antipsychotics such as risperidone, olanzapine, and quetiapine or a MAO-A inhibitor within 3 weeks prior to this study.
8. Dementia (DSM-IV criteria - Amer. Psych. Assoc., 1994). The score on the Mini-Mental State Examination must be \>24.
9. History of stroke (diagnosed on clinical grounds as an acute deterioration of neurological function typical of a stroke; confirmatory CT or MRI evidence of stroke will be useful but not necessary).
10. History of electroconvulsive therapy.
11. History of brain surgery for Parkinson's disease.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Wolfgang Singer, MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wolfgang Singer, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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P01NS044233

Identifier Type: NIH

Identifier Source: secondary_id

View Link

10-008810

Identifier Type: -

Identifier Source: org_study_id

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