Midodrine
Midodrine can be used in individuals to help with vessel vasoconstriction (tightening of blood vessels), which can help increase blood pressure, reduce venous pooling, increase venous tone, and improve orthostatic intolerance (Howraa et al., 2012).
Although some researchers were concerned that Midodrine would be less helpful for individuals with hyperadrenergic POTS (because of the peripheral vasoconstriction), they found that all subjects both with neuropathic POTS and hyperadrenergic POTS benefitted from its use (Ross et al., 2013).
It is important to note that how patients respond may vary, so an individualized and personalized approach is extremely important, considering a patient’s history and unique presentation before assuming that this medication is appropriate.
Sources:
Howraa, A., Patrick A, B., & Le-Xin, W. (2012). Diagnosis and management of postural orthostatic tachycardia syndrome: A brief review. Journal of Geriatric Cardiology, 9(1), 61–67. https://doi.org/10.3724/sp.j.1263.2012.00061
Ross, A. J., Ocon, A. J., Medow, M. S., & Stewart, J. M. (2013). A double-blind placebo-controlled cross-over study of the vascular effects of midodrine in neuropathic compared with hyperadrenergic postural tachycardia syndrome. Clinical Science, 126(4), 289–296. https://doi.org/10.1042/cs20130222