What is pyridostigmine studying for postural tachycardia syndrome?

Pyridostigmine is being studied to see if it can improve rapid heart rate and stabilize blood pressure in people with postural tachycardia syndrome. This trial compares pyridostigmine to a placebo to better understand its effects. The research is sponsored by Mayo Clinic and involves detailed testing of autonomic symptoms.

Who may be eligible for this postural tachycardia syndrome clinical trial?

People aged 15 to 55 with a diagnosis of postural tachycardia syndrome and symptoms like lightheadedness or palpitations may be eligible. Both males and females can join, but pregnant or breastfeeding women are excluded. Other factors include no thyroid disorders and no recent use of pyridostigmine. Please review eligibility criteria for more details.

Is there any cost to participate in this postural tachycardia syndrome clinical trial?

Study-related care, including the study drug or placebo and all trial visits, is provided at no cost. However, personal travel expenses and other costs may vary and are not guaranteed to be covered. Participants should plan accordingly for any travel or accommodation costs.

Actively Recruiting

Phase 2

Age: 15Years - 55Years

All Genders

ID00409435

Double-Blind, Placebo-Controlled Study of Pyridostigmine in Postural Tachycardia Syndrome

Led by Mayo Clinic · Updated on 2026-03-05

Participants Needed

Research Sites

N/A

Total Duration

AI-Summary

What this Trial Is About

Researchers are evaluating pyridostigmine compared to a placebo for treating postural tachycardia syndrome POTS, a condition characterized by rapid heart rate and symptoms like weakness and lightheadedness when standing. This phase 2 study aims to see if pyridostigmine can improve heart rate and stabilize blood pressure in people with POTS. The study is double-blind and placebo-controlled, meaning neither participants nor doctors know who receives the active drug or placebo during the trial. Participants will be randomly assigned to one of two groups one taking 180 mg of time-release pyridostigmine daily, and the other taking a placebo capsule daily, both for 3 days. The study includes two visits to the outpatient General Clinical Research Center. The first visit lasts about 3 hours, and the second visit occurs 2 days later, lasting about 2 hours. During these visits, various tests and procedures assess autonomic and cardiovascular function. During each visit, participants will undergo a medical and neurological exam, height and weight measurement, and complete questionnaires about autonomic symptoms. Tests include an autonomic reflex screen with sweat gland response, cardiovascular recordings, the Valsalva maneuver, and a head-up tilt test. Blood samples will be taken to measure hormone levels while lying down and after standing. Researchers will measure changes in orthostatic symptoms using the Composite Autonomic Symptom Scale and monitor heart rate and plasma norepinephrine changes. Safety and response will be closely observed throughout the short study period.

CONDITIONS

Brief Title

A Study of Pyridostigmine in Postural Tachycardia Syndrome

Who Can Participate

Age: 15Years - 55Years

All Genders

Eligibility Criteria

You may qualify if you...

Diagnosis of postural tachycardia syndrome with orthostatic heart rate increase of 30 bpm or more within 5 minutes of head-up tilt
Presence of symptoms of orthostatic intolerance such as weakness, lightheadedness, blurred vision, nausea, palpitations, or difficulty concentrating
Age between 15 and 55 years
Ability to cooperate with study procedures

You will not qualify if you...

Pregnant or lactating women
Presence of failure of other organ systems or systemic illness affecting autonomic function or study cooperation
Hypothyroidism or hyperthyroidism
Clinically significant coronary artery disease
Use of medications that interfere with autonomic testing
Previous treatment with pyridostigmine for POTS within the past month

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