We tried this one but the side effects- bad stomach aches/abdominal pain was too much without benefit. One medication that helps lower heart rate is beta blockers either metoprolol or propranlol but too much can cause depression and fatigue. I know you have fatigue now but it can get worse. Fluorinef works by increasing the blood volume to get more blood to the brain but it is hard on the kidneys. Some people do well on Midrodrine too.
I can honestly say that Pyridostigmine has been one of the most helpful medications for my Dysautonomia symptoms. I currently take 30mg every four hours. The side effects I experienced upon first taking it were very slight. If I recall correctly, I had occasional stomachaches and shakiness. Some patients experience significant stomachaches with Pyridostigmine, but in my case it actually helped my Gastroparesis symptoms as well. Let us know how it works out for you!
Thank you for answering. I started taking 30 mg every 4-6 hrs, but got a reaction from it and had to cut it back to 15mg evry 4 hrs,. I suffer from asthma and started to get short of breath. Do you know if this is one of the side effects? I am going to try to increase it agaiin in a few days to see what happens.
I am asthmatic as well, and now that you mention it, I did have to increase my preventative medication just as I started the Pyridostigmine. I now take both Symbicort and Qvar. I'm not even sure I made the association at the time. Thankfully, the change in asthma treatment made Pyridostigmine very tolerable. Though not without side effects as you've pointed out, I still find this particular drug to be even more helpful than Midodrine. I am sure it's not for everyone though. I wish you lots of luck! I hope it works out for you! I'm sorry to hear about your asthma flare.
I just wanted to be sure you had seen the treatment page Heiferly and I have been working on for Dysautonomia and Autonomic Dysfunction. In case Pyridostigmine doesn't work out for you, there are several drugs that you might be able to use off-label to treat your symptoms. I wish for you the best of luck!
Treatments for Dysautonomia and Autonomic Dysfunction
I was put on Mestinon by the Mayo Clinic (Dr. Fealey) for my POTS. Here is the dosing schedule they put me on: I started off on 30 mg in the a.m. and then increased to 30 mg in the morning and afternoon (so every 6 hours or so) and then increased to 60 mg in a.m. and 30 mg in afternoon and finally am now on 60 mg twice / day. My side effects at the beginning were nausea and some stomach cramps and some bad headaches but they were definitely tolerable AND they mostly have gone away now that my body is used to the medication / dosage. I have delayed gastric emptying so the drug actually helped my constipation. Overall I have felt better on the medication BUT i will say that my small fiber neuropathy and muscle twitching has gotten worse and they think that may be because of the mestinon so they added neurontin at night (which gave me terrible side effects so i am going off that tonight after a 10 day trial that was horrible). I will be staying on the mestinon for now and if anything will potentially add lyrica or cymbalta for the neuropathy and whatever they can do for my POTS (I was put on Prozac years ago for fibromyalgia but so many newer / potentially more effective drugs have come on the market since then). If i can help with anything else, please just let me know - i'd be happy to hare my experiences further. Keep us posted on how it's going!