In nine patients with orthostatic hypotension due to multiple system atrophy, the effects of octreotide (100 micrograms s.c.), a somatostatin analogue, on blood pressure (BP), heart rate (HR), and norepinephrine (NE) plasma levels after 60 degrees head up tilt test were evaluated by a randomly controlled study. Octreotide increased supine BP, tilt-test duration (+28%), and delay to obtain minimal BP during the 60 degrees head up tilt (+50%). Octreotide changed neither HR nor NE plasma levels.