Consider pharmacotherapy for neurogenic orthostatic hypotension only if non-pharmacological measures fail

A range of primary or secondary autonomic disorders can cause failure of noradrenergic neurotransmission which can subsequently result in a sustained fall in blood pressure upon standing, known as neurogenic orthostatic hypotension. Non-pharmacological measures are the mainstay of treatment of neurogenic orthostatic hypotension. However, when symptoms are not controlled, pharmacological treatment is required. This is largely empirical, based on short- and long-acting drugs, and relies on the use of a variety of agents which target vasoconstriction and intravascular volume expansion. © 2013 Springer International Publishing Switzerland.