Midodrine for POTS/dysautonomia

POTS is characterised by orthostatic intolerance. This means that patients feel significantly worse when they adopt an upright posture compared to when they are lying down.  To try and find effective treatments, it is vital that we try and understand the physiology of what happens in the body when normal healthy people stand up. When we stand up, blood in our vessels tends to get sucked down into [...]

Melatonin for POTS

One of the most prominent and debilitating features of POTS is a very marked increase in heart rate upon adopting an upright posture. This causes the patient to experience very fast heart palpitations which are both scary and very uncomfortable. The patient therefore will try and sit down or lie down to feel better but this is at the cost of becoming increasingly deconditioned in the medium and lo [...]

Brain Fog and Fatigue in POTS – Hope on the horizon?

POTS is a hugely debilitating condition which is characterised by an abnormally high heart rate when the patient adopts an upright posture. A lot of medical research has focused on trying to reduce the heart rate and this does seem to make a beneficial difference in patients with POTS. However virtually every POTS patient that I have looked after will complain of lots of other symptoms which are n [...]

Mestinon: A glimmer of hope for POTs patients

Introduction: Medical care for patients who have a diagnosis of POTS remains hugely unsatisfactory. POTS or rather dysautonomia is a very heterogenous condition. No two people are exactly the same. There is no one single aetiology that can even sometimes be identified. Often the patient who is really suffering looks alright from the outside. Many doctors, largely out of ignorance or perhaps arroga [...]

A ‘pill in the pocket’ for patient with POTS

One of the subjects I have become very interested in POTS. For those who don’t know POTS, it stands for postural orthostatic tachycardia syndrome and is characterised by an excessive increase in heart rate when the patient is upright and this can be extremely unsettling. Along with the racing heart beat, the patient may feel tremulous and dizzy. In addition, patients with POTS have many other symp [...]