Fainting Spells Frequently Related to Multiple Simultaneous Medications

A new study suggests that syncope, a transient loss of consciousness and postural tone commonly known as fainting, occurs more often in patients taking too many drugs at the same time.

Researchers at Copenhagen University Hospital Gentofte (Denmark) conducted an observational study that included 127,508 patients (median age 64, 52.6% female) who were hospitalized for syncope between 1997 and 2009. Of those patients, more than one-fifth had experienced at least two fainting episodes. The researchers reviewed the medications taken by the patients, focusing on drugs known to cause a sudden drop in blood pressure (BP) during posture change. These drugs included widely used types of cardiac medications such as alpha-blockers, beta-blockers, diuretics, calcium channel blockers, and acetylcholine esterase (ACE) inhibitors.

The results showed that cardiovascular disease (CVD) and cardiovascular drug therapy was present in 28% and 48% of the patients that fainted, respectively. The risk of repeat syncope rose with the number of medications that patients were taking at the same time. Compared with people who took no medications, recurrent fainting was 16% more likely for those taking one drug; 20% more likely for those taking two drugs; and 32% more likely for those taking three or more drugs. The study was presented at the annual meeting of the American Heart Association (AHA), held during November 2012 in Los Angeles (CA, USA).

“In a nationwide cohort of patients hospitalized for first syncope, we found significant association between cardiovascular comorbidity and pharmacotherapy and the risk of syncope,” concluded lead author Martin Ruwald, MD, and colleagues of the department of cardiology.

Syncope is characterized by rapid onset, short duration, and spontaneous recovery, usually due to global cerebral hypoperfusion that most often results from hypotension (low BP). Other disorders that could lead to syncope include epileptic seizures, concussion, or a cerebrovascular accident. Syncope needs to be distinguished from coma, which can also include persistent states of loss of consciousness. Syncope is extraordinarily common, occurring for the most part in two age ranges - the teen-age years, and during older age.

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Copenhagen University Hospital Gentofte