Treatment of Orthostatic Hypotension in Cervical Cord Injury with Amezinium Metilsulfate

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The purpose of this study was to evaluate the effect of amezinium metilsulfate (amezinium) on orthostatic hypotension (OH) and physical fitness in cervical cord injuries. Eighteen patients with clinical tetraplegia (mean age of 23.6 years, mean period after injury 3.2 years) were administered amezinium (10 mg/day) orally every day for 8 weeks. Head up tilt test, measurement of CV_R-R with cardiac beat-to-beat variation test and exercise testing using respiratory gas analysis with an arm ergometer were performed before and at 8 weeks after administration. The average minimum level of systolic blood pressure (SBP) with head up tilting rose significantly from 52.8 to 73.5 mmHg and decrease in SBP with tilting was reduced after administration, while the result of measurement of CV_R-R did not change. Mean percentage oxygen uptake (%VO₂) and percentage heart rate (%HR) increased significantly from 38.1 to 43.5% and 54.6 to 63.8% respectively in exercise testing. These results indicate that amezinium is of therapeutic value for the treatment of OH and improvement of physical fitness in cervical cord injuries.