![]() ![]() In this study, we have conducted a systematic review of the best available evidence related to this topic, and we hope to establish clearer and more consistent evidence regarding the association between VVS and psychiatric illness as well as the benefit of using some psychiatric medications in the treatment of VVS. Establishing this relationship will help physicians develop a clearer understanding of this condition, and will allow them to investigate other treatment options. The association between different psychiatric conditions, especially anxiety and depression, and VVS and whether anxiety and depression are risk factors for the development of VVS or they are just an outcome, it’s still not fully understood. ![]() Cardiac pacing is also another treatment option in certain patients. ![]() The treatment of VVS depends primarily on patient education about the condition and its prognosis, non-pharmacological therapies can be used to prevent the symptoms and to prevent syncope at the onset of presyncope, and, if needed, pharmacological options are also available, with many of which focused on blood volume expansion and vasopressor effect. Despite the need and efforts of scientists, there are limited therapeutic options for this condition. Considering the benign nature of VVS, treatment is rarely needed, but in some patients, conservative measures alone are unsatisfactory and effective treatment is needed, as syncopal episodes may result in injury and they may affect the quality of life. Tilt-table testing has been identified as a safe and reliable modality to show susceptibility to VVS, especially in cases where history alone is undiagnostic. The diagnosis of VVS is mainly dependent on history and physical examination. This mechanism that is responsible for VVS differs from baroreceptor-driven blood pressure control by at least two cardinal aspects: first, VVS usually results in hypotension, but the trigger that sets it in motion is not hypertension like is the case in baroreceptor reflex, and second is that blood pressure and heart rate decrease together in most forms of VVS and this reversal of the usual reciprocal behavior indicates that normal baroreceptor reflex is lost during the syncopal episode of VVS. The exact mechanism of VVS has not been identified, with the main hypothesis suggesting a paradoxical reaction of the autonomic nervous system that causes hypotension and/or bradycardia. Vasovagal syncope (VVS) is the most common cause of syncope, with around one-third of all people having at least one syncopal episode during their lifetime. It’s also considered a financial burden with the median cost of hospitalization around $8679. It’s a very common problem with an estimated lifetime prevalence of around 40%. Syncope is a transient and sudden loss of consciousness followed by complete retention of function. The use of psychotherapy and antidepressants was proven to be effective in VVS in RCTs, but further evidence is needed. We found a consistent correlation among VVS, psychosocial impairment, and quality of life (QoL), meaning that VVS patients usually have some degree of psychosocial impairment, especially in the form of anxiety and depression, and a poorer QoL in comparison to their healthy counterparts. Four of the included studies assessed the correlation among vasovagal syncope, psychosocial impairment, and quality of life. ![]() The search resulted in 1691 articles, and inclusion and exclusion criteria were applied to nine remaining articles, all of which were accepted after using the quality assessment tools, four observational and four randomized controlled trials (RCTs). We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the available literature using the following databases: PubMed, Google Scholar, and ScienceDirect, with last access on July 21, 2022. In this study, we assessed the correlation between VVS and a patient’s psychiatric status, as well as if this association could be a target in the treatment of those patients. Vasovagal syncope (VVS) is a transient, sudden loss of consciousness followed by complete resolution, usually due to a paradoxical autonomic reaction that results in hypotension and/or bradycardia. ![]()
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