Midodrine Alternatives?

[mkoven]

thought i'd start a new thread, for those of us who are pessimistic about being able to keep getting midodrine. it seems it's iunique as a vasoconstrictor without cns effects. would phenylephrine do something similar? sudafed?

[roxie]

My dr did try me on Sudafed once. It didn't do anything but neither did Midodrine.

I'd say if definitely worth a try if you can't get Midodrine

[Rachel]

Great thread!

Some people use SSRIs. Seratonin aids in vasoconstriction, and for some people an SSRI gives a benefit similar to that of midodrine. I've tried a few SSRIs over the years, but none of them were helpful for me. If midodrine is no longer available, though, I will be talking to my cardiologist about trying an SSRI again.

[iheartcats]

What types of SSRIs do people take? I have to go see my specialist in a couple of months because of this.

I prefer something that's been around awhile (generic!) so would rather start with that and go from there.

Does anyone take SSRI's with Beta Blockers? I just can't give up my beloved propranonol.

[roxie]

I take 20mg of Prozac. It was really hard to adjust too at first. When I tried to go up to 25 I was like in a fog all the time though. So it needs to be controlled with a good dr.

Does Prozac really work the same ad Midodine?

Another thing you could try, that my dr has me do, is ice therapy. I pack my legs in once for 20minutes 3 times a day. It's a pain in the butt, but my dr says cold contrists. ?I tried it when I was on Midodrine & my bp immediately went sky high, so it much constrict some.

[iheartcats]

I was reading Celexa (Citalopram generic) was similar to Lexapro.

Others with generic are Prozac, Effexor, and Zoloft.

I'm not sure if Prozac has the midodrine effect, but it is an SSRI.

Anyone who can share any info on these will be great. I think I'll talk to my specialist about Celexa (generic). I know generic versus brand can be picky for antidepressants but that's what I want to start on generic (much more affordable for me and if one works, wonderful).

[Rachel]

Non prescription helps in raising blood pressure:

compression hose

abdominal binders

coffee

cold (wear flip-flops or no shoes when it is chilly)

[potsgirl]

Never mind....I read down further and found the study regarding Midodrine.... I'm not currently taking it because it didn't seem to work for me, but I will advocate for Paxil, which I've been taking for about 10 years now. Start slowly and work your way up. I still only take 15 mg, but I also take a little Clonazepam and Trazodone for sleep.

[erik]

I haven't taken midodrine (was just getting to the point of asking to try it) but I refer to pseudoeffedrine as my "poor man's midodrine" which I have used in the past in an attempt to do something similar. I am unsure how much CNS interaction it has or how well it would fill in for midodrine. I get a bit palpy on pseudoeffedrine. There is also phenylephrine, a substitute for pseudoeffedrine that is said to do it's thing "indirectly"... presumably by norepinephrine release/activation... whereas I think pseudoeffedrine is credited with being a direct alpha-agonist more akin to midodrine. Both are over-the-counter, though typically you have to sign for pseudoeffedrine due to illicit-drug precursor prevention efforts.

Welbutrin (buproprion) might offer potential BP increase and fall short of full on stimulants (still lending itself to insomnia for some folks though). ProVigil might do this indirectly a little too but not sure how much it's known for that. The SSNRI's sometimes boost BP I think. All these less direct options get tricky and are probably quite "trial & error" like everything else.

[dakota]

Cat_Lady, my daughter takes both propranolol and paxil, so you can mix a beta blocker and an SSRI.

[iheartcats]

Thank you, Dakota. That's a relief.

Now...I have to figure out how much midodrine I have left. I assume I'll have to wean off! Anyone else think they will, too?

[Noreen]

Vanderbilt is studying different drugs according to this -

http://clinicaltrials.gov/ct2/show?cond=%2...%22&rank=21

I hadn't run across this link for the Autonomic Disorders Consortium Participating c?linical Centers before so I am posting it here before I lose it entirely.

http://rarediseasesnetwork.epi.usf.edu/ARD...nters/index.htm

[cnm1]

I don't think there are good substitutes. It should stay available in foreign countries. I think this must be fought - it has given my daughter her life back. This is all about money - it always is with drugs!!!

louise

[Sarah4444]

I just started taking Midodrine today, and I live in Canada. It hasn't been available recently but my pharmacist was told that it should be again relatively soon. I called a Canadian online pharmacy and they said they should have it again in about two weeks. I am new to the forum - I have had trouble with dysautonomia for 26 years but didn't know what it was, and am just in the process of getting diagnosed now. I don't know if you can get my email address through the site, but I'd be happy to keep people posted re availability of the drug up here.

[DancingLight]

A very, very long time ago there was a discussion about midodrine and its unique properties. Sunfish went into great detail about the drug, and I'm afraid I'm going to get the information wrong, but I'm going to give it a try and maybe someone else can chip in.

I remember her saying that midodrine was the first drug approved for OI, and that it was basically 'part' of ritalin. It was discovered that ritalin raised blood pressure and this was helpful a negative side effect for those with ADD, but not for OI. So, midodrine was developed from ritalin, without all of the side effects of agitation, etc.

Some folks are able to tolerate stimulants like ritalin and do well with them. I did not. But, they have the bonus of raising BP.

I hope I sort of got this right...

emily

[ramakentesh]

The only real substitutes for midodrine are other alpha agonists. Didhydroergotamine (DHE), Droxydopa, and butchers broom are effective alpha agonists - DHE is a selective venous alpha agonist.

[ramakentesh]

Synephrine and phenylephrine are both selective alpha 1 agonists.