lgtaylor100 Posted May 8, 2011 Report Share Posted May 8, 2011 I recently went to an autonomic specialist who prescribed amitryptiline and coreg as a treatment for autonomic dysfunction.I have been on these meds for six days and am so confused about whether to continue. I have gone to four cardiologists in the last six months and between them and my primary they have suggested five different treatment plans. My regular cardiologist prescribed attenolol and midrodine, the cardiologist that diagnosed POTS in January said attenolol as needed; one POTS specialist said no beta blocker just use midodrine, and the latest autonomic specialist said coreg, midodrine, and amitryptaline. My primary originally said attenolol but values the opinion of the autonomic specialist and said stick with his treatment plan.I've been on this treatment plan for six days and I believe my heart rate is higher than usual ( I am attributing this to the amitryptiline). I have never fainted before but came really close today (and I am attributing this to the coreg.)The symptoms are frightening and I don't know if the new meds are making things worse.I know everyone is different but I'm wondering if anyone else has tried this combination of meds and what was the result.Lynne Quote Link to comment Share on other sites More sharing options...
cmruls Posted May 8, 2011 Report Share Posted May 8, 2011 I currently take these meds with good results. Coreg and bystolic are the only 2 BB's that cross the blood brain barrier and have an effect on the central nuclei in the CNS/ANS. They are used in much smaller doses than are used in HTN and heart patients. Small doses of amitriptlyine (non anti depression doses) are also used and can help sleep patterns and calm the ANS. If you have a jump in HR or a fall in BP when you stand then they will use small doses of midodrine to support the orthostasis. Quote Link to comment Share on other sites More sharing options...
55baron Posted May 8, 2011 Report Share Posted May 8, 2011 My daughter has been on a beta blocker, started with atenolol then went to metoprolol (to block heart rate from going to high), amitryptiline (to control headache), midodrine (to raise blood pressure), florinef to increase blood flow), she has ben on then for about 5 years. This year has been the best in 5 years! (knock wood). It took her a few years of adjusting the dosage to get it right for her.There are ALOT of protocols for treating pots, you have to try things one at a time to see what works and what doesn't.Good luck Quote Link to comment Share on other sites More sharing options...
janiedelite Posted May 9, 2011 Report Share Posted May 9, 2011 For me, coreg at 6.25mg twice daily actually helps improve my BP and heartrate and energy levels. I was hospitalized a couple years ago with high troponin and chest pain and responded well to oxygen but also to nitrates. Coreg helps control my chest pain and also improves my energy levels a bit. I tried to raise the dose but only got more fatigued. I wanted to try amitryptilline for my small fiber neuropathy pain but the neurologist said it would only worsen my OI. Bummer... Quote Link to comment Share on other sites More sharing options...
seaboardbc Posted May 9, 2011 Report Share Posted May 9, 2011 Coreg has been a lifesaver for me. I take the extended release formula and I think that makes a difference. Quote Link to comment Share on other sites More sharing options...
cmruls Posted May 9, 2011 Report Share Posted May 9, 2011 Amitryptilline in higher anti-depression doses can worsen OI, but at low dose for dysautonomia this is a rarer side effect and is tolerated well. Quote Link to comment Share on other sites More sharing options...
usports2 Posted May 10, 2011 Report Share Posted May 10, 2011 My son was on Amitryptilline for 18 months ~ during a portion of his misdiagnosis period.I would never have him on it again! He totally lost his affect...he was not the child that we knew. Almost as if he was hiding inside a shell.He was agitated, always on edge, lethargic, and had a general sense of not caring.Additionally, though he was not diagnosed at the time with POTS, the symptoms that he was experiencing that we now know to be caused by POTS, were not helped in the least...if anything, things were worse. Quote Link to comment Share on other sites More sharing options...
Rachel Posted May 12, 2011 Report Share Posted May 12, 2011 I take amitriptyline (30mg a day) for migraines, and it has been helpful for me. My migraines come with extreme sensitivity to sights and sounds, and my neurologist said that amitriptyline would help with that specific migraine symptom more than the Topamax that I had been on previously. I haven't noticed that the amitriptyline helps with any of my other dysautonomia symptoms. It does make me a little sleepy 2 hours after I take it, but I still have to take melatonin to sleep at night; so I wouldn't say that the amitriptyline helps with sleep for me, though it does for others. I haven't had any side effects at 30mg of amitriptyline, but I did at 40mg. The 40mg dose caused too much fluid build up and pain in/behind my eyes.I have never tried Coreg, so I can't share anything there.You might find it helpful to start just one new medication at a time. That way you can know for certain which med is causing which side effects, or which med may be helping.I hope that you can find a good medication combination. It can be a long and hard process, but don't give up!All the best,Rachel Quote Link to comment Share on other sites More sharing options...
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