Refractory orthostatic hypotension in a patient with a spinal cord injury: Treatment with droxidopa

Orthostatic hypotension (OH) is a common issue for those with spinal cord injuries, especially those with complete injuries above T6. This means their blood pressure drops when they stand up. This report discusses a 65-year-old man with a spinal cord injury who had severe OH that didn't respond to standard treatments. The doctors tried a medication called droxidopa, and it helped. Droxidopa is a drug that can increase blood pressure. In this case, it helped the patient's blood pressure rise and improved his symptoms related to OH, allowing him to progress in his rehabilitation.

• 1
  Droxidopa increased blood pressure levels in the patient, specifically a 10 mm Hg increase in systolic BP and 6 mm Hg in diastolic BP in the supine position.
• 2
  The patient reported a subjective improvement in symptoms such as fatigue and cognitive function after starting droxidopa, with only occasional dizziness upon rising.
• 3
  The patient did not experience significant side effects such as hypertension in a supine position or an increased heart rate while taking droxidopa.