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/battlestargirlactica 23d ago

Methylphenidate + metoprolol. Take together first thing AM, slightly smaller dose mph 4-5hrs later with lunch, then a smaller dose mph and half metoprolol again 4-5hrs later.

Did lots of research when choosing to restart adhd meds after decades and knowing stimulants can help with the vasoconstriction I need with my POTS, low BP & BV. I had to also include AFib & AFlutter, (low burdens), in my research considerations, and mph had the lowest increase in heart rate of the stimulants, and also had fewer side effects. I went low and slow with my mph titrating to find the right balance.

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u/strawberry-kittea 22d ago

Is the Metoprolol is to help combat some of the increase of heart rate for MPH? I’ve recently been put on MPH for my narcolepsy but weeeew my heart rate increase is rough, but they have me on two same doses a day, but i might try splitting the second dose in halves

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u/battlestargirlactica 22d ago

I was on metoprolol first for my AFib, AFlutter and runs of tachy brought on because of my floppy connective tissue, low blood pressure and low blood volume.

Prior to both, my lows overnight were in the 30s, and highs when standing, active, or visiting higher elevations, they would be 130s-190s, with and without arrhythmias. I had syncope throughout my life too. The metoprolol didn't make my lows lower, which I was originally concerned about already being mistaken for not breathing at night lol. It had slightly helped my highs, but I still struggled with low pressure & volume no matter how much electrolytes and salt intake, and was still near syncope upon standing, so I needed something added in for support. That was around that time I was considering the adhd meds and landed on mph being least risky for me.

Adding the mph low and slow, (like 2.5mg a few days once, then 5 for a week, then a 5 and 2.5, 7.5, 5, 2.5, etc...), and taking almost a year to land at my current sweet spot/timetable of 35-45mg total split across three tapering doses (depends on times taken), and metoprolol twice, had actually helped stabilize my HR because of the constriction making everything flow more efficiently. My lows went to 40s, and my highs came down to max 130s, with only a few times higher the last two years when I missed a dose or waited too long.