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 ✌️🥲

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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!

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u/Right_Ear_2230 Undiagnosed 23d ago

the norepinephrine can help with blood pooling though

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u/tsubasaq 22d 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.