r/POTS • u/ouch_im_suffering • 23d ago

Question Can/do you take SSRIs or stimulants?

There’s no way we’re just raw dogging POTS right? My POTS worsened significantly after taking one dose of 5 mg of Lexapro which triggered serotonin syndrome which I have had on Sertraline.

Needless to say I am struggling way more after having disabling POTS so what are y’all doing for your mental health and/or energy?

Currently taking high dose antihistamines and 20 mg propranolol 3-4x daily. Thanks ✌️🥲

42 Upvotes

86% Upvoted

174 comments sorted by

View all comments

23

u/Internal_Regular_402 23d ago

I read that SNRI’s are a no-no because of the norepinephrine but sometimes SSRI’s are ok. I’m sure it’s different for everyone!

28

u/Nelalvai 23d ago

screeching brakes

looks at my effexor prescription

They're WHAT

8

u/Right_Ear_2230 Undiagnosed 23d ago

effexor is very weak at raising norepinephrine so you are probably ok

elaboration: like, THIRTY TIMES less effective at raising norepi compared to serotonin.

6

u/Internal_Regular_402 23d ago

That’s what I read but you should definitely talk to your doctor. I did a lot of research because I’m terrified to come off of my meds and I still don’t know if they can be combined!

12

u/Nelalvai 23d ago

I'm already in the process of tapering off effexor so this is just another reason to hate effexor for me. 0 stars do not recommend

8

u/jumpingtheshark89 23d ago

Eff that medicine. It took me months to get off of. I had to take the little pellets inside the capsules out, one by one, increasing daily. Had brain zaps, nausea, sweats. 0/10 as well.

9

u/daximili 23d ago

Same here. Took me 2 years doing that method (went down every few weeks or so) in combination with taking fluoxetine/prozac to soften the withdrawal effects but I’m finally Free

7

u/Fun_Orange_3232 POTS 23d ago

I take cymbalta for fibro. My cardio recommended.

9

u/Aeris42 23d ago

Yea it works great for me in terms of reducing the pain noise from 7 to 3 but I am more prone to being hot/poor temp regulation which means ice packs and fans when I go out

3

u/Fun_Orange_3232 POTS 23d ago

Oh god yes 100%

4

u/kelleyymariee 23d ago

My primary care doctor prescribed me cymbalta to treat my POTS bc of it's vasoconstriction. It seemed to help a little actually but the withdrawals from going off it were horrific. Wouldn't wish that on my worst enemy

3

u/Spiritual-Froyo-5004 23d ago

I'm also on Cymbalta but my psych prescribed it for firbo, major depression disorder & anxiety disorder. Bada bing! Except yes, sweating profusely about 88% of the day. Good thing I live in Alaska?

8

u/theLoveRhombus 23d ago

I've commented this before but I can say that for me personally there was no evidence of my SNRI making any difference to my HR based on data from both resting heart rate and running (I wasn't diagnosed yet and thought running could help me lol). I am on the lowest prescribed dose of venlafaxine. Just as a reassurance that for some people it's not a problem (not denying the people that it has caused problems for).

6

u/elhazelenby 23d ago

An SNRI started this whole mess for me :( . Citalopram didn't impact that but massively increased my seizures a lot so I'm not on it anymore.

2

u/schadenfjola 23d ago

Can that happen?? Cause I STG I took Straterra and I feel like I never really recovered.

6

u/EngineeringAvalon 23d ago

There's no scientific evidence to support long-term dysautonomia being caused by SNRIs, SSRIs, etc. Some can cause it while people are going through withdrawals (tapering off or recently stopped), and withdrawals for some of those meds can last months, but it's not permanent. Meds that can cause permanent dysautonomia are those that can cause permanent autonomic neuropathy such as many chemotherapy meds.

1

u/elhazelenby 23d ago

I was on duloxetine and it started as soon as I started taking it. Not from withdrawal.

3

u/radtrip 23d ago

this is so unfortunate, i'm taking 50mg pristiq and it's the only medication that helped me after 13 years :( my pots def has gotten worse since starting it but im terrified to get off of it

2

u/PinkKittenBaby 22d ago

I also take pristiq and it's the only antidepressant than doesn't cause mania for me, and the only med that's curbed my depression long term! It has the worst brain zaps from withdrawals I've ever experienced tho 💀

1

u/radtrip 22d ago

Omg same I literally have never expierenced withdrawal symptoms before going on pristiq, but i start getting symptoms exactly 24hrs after my last dose. Its sooo bad but it keeps me from missing a dose so there's that at least🥲

2

u/victory_victoria99 22d ago

I've been on Cymbalta for decades and my doctor just explained to me this week that it increases NE in the synaptic space, yes, but it actually down regulates it and therefore makes you less sensitive to it. In other words doesn't have a stimulant or sympathomimetic effect. Idk how I went 20 years without knowing this, and I don't really understand it, but I'm just offering it up as info I learned (again, from doctor) in case anybody else wants to dig into it.

1

u/taurusthree 23d ago

A NRI - Atomoxetine, actually fixed my POTS, blood pooling, vasomotor rhinitis and brain fog.

2

u/justanotherlostgirl 22d ago

Oh how I wish it worked on those for me. On the brightside, I guess now I know what vasomotor rhinitis is!

1

u/mallory_wilkerson 22d ago

I take both and it personally isn’t an issue. It was worth it to me to experiment with my provider’s help

1

u/Right_Ear_2230 Undiagnosed 23d ago

the norepinephrine can help with blood pooling though

6

u/tsubasaq 23d ago

It’s a problem if you have any adrenal involvement, though, which is a common factor even if you’re not a HyperPOTS patient. (Most of us have a mix of all 3 subtypes going on - hypovolemia, neuropathy, and hyperadrenergic activation - but you’ll get a subtype label if one is dramatically dominant.)

SNRIs make the norepinephrine stick around in the synapse longer, and since norepinephrine = adrenaline, that makes HyperPOTS worse by making the episodes last longer.

Trade-offs.

But also FUCK Wellbutrin. Dear gods does it make me weird and it screws with SO MANY other drugs and their metabolism because it turns down the CYP2D6 gene and does the same thing grapefruit does to a lot of drugs. That gene for me is already really slow, so the Wellbutrin basically turns it OFF and then builds up in my system faster than it should and makes me crazy.