What's the treatment for Shy-Drager syndrome?
There is no cure for the disorder and no known means to slow progression. The treatment is aimed at controlling symptoms such as postural hypotension and parkinsonian movements.
Medication can relieve many of the symptoms, especially the parkinsonism and low blood pressure. However, typical antiparkinsonism drugs such as carbidopa-levodopa (Sinemet) should be used with caution, since they often worsen the postural low blood pressure and may cause fainting.
Carbidopa may reduce the side effects of Levodopa and make the Levodopa work better. The response to medications may be disappointing. Many affected individuals respond poorly to treatment with anticholinergics or Levodopa. Sympathomimetics, vasoconstrictors, beta-blockers, MAO inhibitors, vasopressin, 9-fluohydrocortisone, or other medications may be used to treat low blood pressure (postural hypotension).
Because postural hypotension is the most troublesome of the symptoms in the early years, treatments center on relieving this problem. Patients are encouraged to eat a liberal salt diet and drink plenty of fluids. They are advised to wear waist-high elastic hosiery and to sleep with the head elevated at least 5 in (13 cm). Other drug treatment includes fludrocortisone, indomethacin, nonsteroidal anti-inflammatory drugs, beta blockers, central stimulants, and other medications.
Occasionally, a pacemaker, gastrostomy, or tracheostomy may be needed. A pacemaker is a device that delivers electrical impulses to the heart to keep it beating regularly. A gastrostomy creates an opening in the stomach to connect a feeding tube from outside the body. In a tracheostomy an opening is made in the windpipe and a tube is inserted to maintain breathing.