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Gac Med Mex. 2008 Nov-Dec;144(6):503-7.

[Comparison of metoprolol vs clonazepam as a first treatment choice among patients with neurocardiogenic syncope].

[Article in Spanish]

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Departamento de Electrocardiología, Instituto Nacional de Cardiología Ignacio Chávez, SSA, Tlalpan, México DF, México.



We compared the effects of a metoprolol and clonazepam in patients with neurocardiogenic syncope.


We compared the effects of a metoprolol and clonazepam in a prospective, randomised trial in 54 patients. Patients were randomly assigned to metoprolol (starting dose 50 mg bid) or clonazepam (starting dose 0.5 mg qd). We assessed a primary combined endpoint of syncope and pre-syncope on a follow-up of 12 months.


The primary combined endpoint of syncope and presyncope occurred in the metoprolol group in 3, 4, and 10% of patients at 3, 6, and 12 months respectively. In the clonazepam group it was no recurrence in the first 6 months, and 5% recurrence at 12 months follow-up (nonsignificant differences between groups). Clinical symptoms commonly associated with neurally mediated syncope were decreased similarly in both treatment groups, in the metoprolol group from 5.2+/-2.5 to 1.9+/-2.1 (p < 0.001) and in the clonazepam group from 5.5+/-2.5 to 1.5+/-2.2 (p<0.001).


Pharmacological treatment of neurocardiogenic syncope with metoprolol or clonazepam resulted in similar prevention of syncope and presyncope. Both treatments decreased clinical symptoms but complete symptomatic resolution was rarely observed.

[Indexed for MEDLINE]

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