Methods: The investigators will conduct a prospective, randomized, parallel, double-blind, proof-of-concept study to test the hypothesis that norepinephrine transporter inhibition with Atomoxetine prevents tilt-induced vasovagal syncope (VVS)/pre-syncope in patients with clinical vasovagal syncope. Subjects will have had ≥1 faint in the previous year, and a diagnosis of vasovagal syncope based on the Calgary Syncope Symptom Score. The primary outcome measure will be the time to syncope or presyncope with a trough rate-pressure product <7000 mm Hg/min. The primary analysis will be performed on an intention-to-treat basis. Secondary analyses will include modelled estimations of systemic vascular resistance and stroke volume, based on arterial waveform and blood pressure. This will permit us to address whether NET inhibition prevents the vasovagal reflex by maintenance of cardiac preload or maintenance of systemic vascular resistance. The investigators will randomize 64 patients in a double blind acute phase 2 study to either Atomoxetine 40mg PO BID x 2 doses or matching placebo.