Angiotensin Ii Upregulates Sympathetic Drive

[julieph85]

That's exactly what I was thinking! There has got to be something going on with that receptor. I wish there was some way to trial the only FDA approved Nk1 antagonist. Didn't you used to have horrible trouble with nausea and vomiting? That is directly connected to that receptor, and the approved NK1 antagonist is indicated as an antiemetic.

[julieph85]

substance P suppresses somatostatin expression!

http://www.jimmunol.org/content/161/11/6316.abstract

[jangle]

Yes I did, and others have as well. I think it's a common presentation with POTS. I think you would have to go to an open minded doctor to get them to prescribe you aprepitant for POTS. It might be a little easier if you still are having nausea and vomiting with your POTS. (Or tell them you do hehe)

One thing is for sure, waiting for a researcher + FDA approval for POTS would be waiting to 2020 at the minimum.

EDIT: Julie that's interesting that they have opposing effects on each other. That would seem to suggest that perhaps an alternative to octeotride would be to block the substance P which would have (effectively) the same effect as raising somatostatin levels.

[julieph85]

Yes I did, and others have as well. I think it's a common presentation with POTS. I think you would have to go to an open minded doctor to get them to prescribe you aprepitant for POTS. It might be a little easier if you still are having nausea and vomiting with your POTS. (Or tell them you do hehe)

One thing is for sure, waiting for a researcher + FDA approval for POTS would be waiting to 2020 at the minimum.

EDIT: Julie that's interesting that they have opposing effects on each other. That would seem to suggest that perhaps an alternative to octeotride would be to block the substance P which would have (effectively) the same effect as raising somatostatin levels.

yes, absoluely. There are SP antagonists out there, but i believe none have fda approval yet.

[julieph85]

http://www.fibro-info.com/fibro-serotonin.html

This obviously isn't a scholarly source, but notice the claim tha elevated substance p lowers serotonin.

[jangle]

Julie, aprepitant is an SP antagonist that received approval from the FDA.

[julieph85]

I thought arepitant was a NK-1 recpetor antagonist? It would work the same way at blocking SP because it is dependent on that recpetor, but I don't think it's a true SP antagonist. NK-1 ant. blocks several other enzymes besides SP, I was talking about a specific SP antagonist only.

[ramakentesh]

Substance P was reviewed and disregarded in POTS in 2006. David Robertson did the work.

[julieph85]

Thanks Rama! That's good info. I wonder if they only were testing in a specific subset though. Maybe it's only not a factor for some? It seems like there can be many different causes for different people. Like some could be a neuro endocrine cause, some ang 2, some neuropathy, etc. so how do the researchers know what makes up their testing pools? I think this issue is why we don't know the subtypes yet.