Best treatment for Hyperadrenergic POTS?

[kluesy]

Can anyone tell me what has been an effective treatment for Hyperadrenergic POTS?

I was diagnosed this past year, but have had no luck with medication.  Tried Aldomet(methy-dopa), propranonol both of which made me worse and Mestinon which helped with muscle weakness but caused bad asthma, so I had to stop.

Compression hose and increased salt and gatorade helped some.

I think I also have a mast cell activity disorder as I have facial and chest flushing and 20 years of chronic angioedemas. Daily zyrtec, benadryl and pepcid seem to control the swellings.

Any information would be greatly appreciated!!

[evo123]

I have mostly BP increases too when standing, and have recently been dx with blood pooling!  In April I was started on Midodrine.  I was really worried about this but I have not had any negative side effects.  I have not had any improvement with it yet, but I am only on a small dose to start with.

I had to be an inpatient to start on this so my BP could be monitored.  Are you starting on this at home or under supervision? X

[kluesy]

thanks for the suggestions!!! going to try a very sm dose of Midodrine(neurologist ordered) to try to keep blood from pooling in legs and abdomen.

  I know many have had problems with too high bp and hr, (with the hyperadrenergic) but my increases are a direct result of the blood pooling, so if I can prevent my body from having the adrenaline, ect surges(due to blood pooling) by constricting my blood vessels, maybe it will help,.

Willing to try....will let you know.

[evo123]

Below is a link to table by Dr. Blair Grubb stating medications used for POTS, H indicates meds used for the Hyperadrenergic form:

http://circ.ahajournals.org/cgi/content-nw/full/117/21/2814/TBL2189801

Here is the link to the article this table is included in:

http://circ.ahajournals.org/cgi/content/full/117/21/2814#SEC4

Hope this helps x

[LivingInHope]

The benadryl might, as it can,  be causing you worse tachycardia?

Diagnosed by tilt table with P.O.T.S. in 2004,  I suspect I have that form of P.O.T.S. (hyperadrenergic) due to various abnormal catecholamine type numbers in a number of lab tests.  Medicines that were tried and discontinued for either side effects or not helping- lopressor, florinef, midodrine, and verapamil.  Currently, I am not being treated by any physician for my P.O.T.S..  After a recent abnormal holter monitor, during which my heart climbed as high as 160 (standing after sleeping), a doctor asked me if I'd ever taken digoxin.  I don't believe I have, but am afraid to try it with possible toxicity and scary side effects, plus I looked up digoxin and didn't see my condition listed as to what it's used for.

I'd be interested to know if something I could take would work too!