Treatment for<unk>  focuses on avoidance of triggers, restoring blood flow to the brain during an impending episode, and measures that interrupt or prevent the pathophysiologic mechanism described above. Lifestyle changes * The cornerstone of treatment is avoidance of triggers known to cause<unk>  in that person. However, research has shown that people show great reductions in vasovagal<unk>  through exposure-based exercises with therapists if the trigger is mental or emotional, e.g., sight of blood. However, if the trigger is a specific drug, then avoidance is the only treatment. * A technique known as "applied tension" may be additionally useful in those who have<unk>  with exposure to blood. The technique is done by tightening the skeletal muscles for about 15 seconds when the exposure occurs and then slowing releasing them. This is then repeated every 30 seconds for a few minutes. * Because vasovagal<unk>  causes a decrease in blood pressure, relaxing the entire body as a mode of avoidance is not favorable. A person can move or cross their legs and tighten leg muscles to keep blood pressure from dropping so significantly before an injection. * Before known triggering events, the affected person may increase consumption of salt and fluids to increase blood volume. Sports drinks or drinks with electrolytes may be helpful. * People should be educated on how to respond to further episodes of<unk> , especially if they experience prodromal warning signs: they should lie down and raise their legs, or at least lower their head to increase blood flow to the brain. At the very least, upon the onset of initial symptoms the patient should try to relocate to a 'safe', perhaps cushioned, location in case of losing consciousness. Positioning themselves in a way where the impact from falling or collapsing would be minimized is ideal. The 'safe' area should be within close proximity, since, time is of the essence and these symptoms usually climax to loss of consciousness within a matter of minutes. If the individual has lost consciousness, he or she should be laid down in the recovery position. Tight clothing should be loosened. If the inciting factor is known, it should be removed if possible (for instance, the cause of pain). * Wearing graded compression stockings may be helpful. Medications * Certain medications may also be helpful: * Beta blockers (β-adrenergic antagonists) were once the most common medication given; however, they have been shown to be ineffective in a variety of studies and are thus no longer prescribed. In addition, they may cause the<unk>  by lowering the blood pressure and heart rate. * Medications which may be effective include: CNS stimulants fludrocortisone, midodrine, SSRIs such as paroxetine or sertraline, disopyramide, and, in health-care settings where a<unk>  is anticipated, atropine or epinephrine (adrenaline). * For people with the cardioinhibitory form of vasovagal<unk> , implantation of a permanent pacemaker may be beneficial or even curative. Types of long-term therapy for vasovagal<unk>  include * Preload agents * Vasoconstrictors * Anticholinergic agents * Negative cardiac inotropes * Central agents * Mechanical device * Discontinuation of medications known to lower blood pressure may be helpful, but stopping antihypertensive drugs can also be dangerous in some people. Taking antihypertensive drugs may worsen the<unk> , as the hypertension may have been the body's way to compensate for the low blood pressure.
Reflex syncope
Hypotonic-hyporesponsive episode
Heat syncope
Laughter-induced syncope
Reflex asystolic syncope
Panic attack
Hair-grooming syncope
Postural orthostatic tachycardia syndrome