Study of Atomoxetine in the Prevention of Vasovagal Syncope

Inclusion Criteria: 1. Syncope according to the American College of Cardiology Guidelines 2017 2. At least 2 vasovagal syncope spells in the preceding 12 months 3. At least -2 on the Syncope Symptom Score for Structurally Normal Hearts 4. At least 18 years old with informed consent Exclusion Criteria: 1. Other cause of syncope 2. A 5-minute stand test resulting in the diagnosis Orthostatic Hypotension or Postural Orthostatic Tachycardia Syndrome 3. An inability to give informed consent 4. Pregnant 5. Unwilling or unable to use adequate birth control while on study drug. 6. An important valvular, coronary, myocardial, or conduction abnormality, or significant arrhythmia 7. Uncontrolled hypertension 8. Uncontrolled hyperthyroidism 9. A permanent pacemaker 10. Taking or has recently taken a monoamine oxidase inhibitor 11. Pheochromocytoma 12. Glaucoma 13. Prior use of atomoxetine for syncope 14. Clinical need for atomoxetine or another potent norepinephrine transporter inhibitors (Ki NET \< Ki SERT, Ki NET \> 10 Ki atomoxetine), 15. Current use of β-blocker, bupropion, α1-adrenergic agonists or antagonists, tricyclic antidepressants, serotonin reuptake inhibitors, scopolamine, theophylline, or fludrocortisone.