arizona girl Posted June 20, 2012 Report Share Posted June 20, 2012 Another center review of Pyridostigmine when used to treat pots, they don't say exactly with the improvement was in bp/hr so I don't know if they meant it helped patients who BP went up or down.Rama, what do you think?Pacing Clin Electrophysiol. 2011 Mar 16. doi: 10.1111/j.1540-8159.2011.03047.x.Pyridostigmine in the Treatment of Postural Orthostatic Tachycardia: A Single-Center ExperienceKanjwal K, Karabin B, Sheikh M, Elmer L, Kanjwal Y, Saeed B, Grubb BPElectrophysiology Section, Division of Cardiology, Department of Medicine, The University of Toledo, Toledo, Ohio Department of Neurology, The University of Toledo College of Medicine, Health Science Campus, Toledo, Ohio]The long-term efficacy of pyridostigmine, a reversible acetyl cholinesterase inhibitor, in the treatment of postural orthostatic tachycardia syndrome (POTS) patients remains unclear. We report our retrospective, single-center, long-term experience regarding the efficacy and adverse effect profile of pyridostigmine in the treatment of POTS patients. Methods: This retrospective study included an extensive review of electronic charts and data collection in regards to patient demographics, orthostatic parameters, side-effect profile, subjective response to therapy, as well as laboratory studies recorded at each follow-up visit to our institution's Syncope and Autonomic Disorders Center. The response to pyridostigmine therapy was considered successful if patient had both symptom relief in addition to an objective response in orthostatic hemodynamic parameters (heart rate and blood pressure). Three hundred patients with POTS were screened for evaluation in this study. Of these 300, 203 patients with POTS who received pyridostigmine therapy were reviewed. Of these 203 patients, 168 were able to tolerate the medication after careful dose titration. The mean follow-up duration in this group of patients was 12 ± 3 (9-15) months. Pyridostigmine improved symptoms of orthostatic intolerance in 88 of 203 (43%) of total patients or 88 of 172 (51%) who were able to tolerate the drug. The symptoms that improved the most included fatigue (55%), palpitations (60%), presyncope (60%), and syncope (48%).Symptom reduction correlated with a statistically significant improvement in upright HR and diastolic blood pressure after treatment with pyridostigmine as compared to their baseline hemodynamic parameters (standing HR 94 ± 19 vs 82 ± 16, P < 0.003, standing diastolic blood pressure 71 ± 11 vs 74 ± 12, P < 0.02). Gastrointestinal problems were the most common adverse effects (n = 39, 19%) reported.The overall efficacy of pyridostigmine in our study was seen in 42% of total patients or 52% of patients who could tolerate taking the drug. Conclusion: The subgroup of POTS patients who can tolerate oral pyridostigmine may demonstrate improvement in their standing HR, standing diastolic blood pressure, and clinical symptoms of orthostatic intolerance©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc] Quote Link to comment Share on other sites More sharing options...
sue1234 Posted June 20, 2012 Report Share Posted June 20, 2012 Is it for someone with hyperPOTS? Quote Link to comment Share on other sites More sharing options...
arizona girl Posted June 20, 2012 Author Report Share Posted June 20, 2012 The title of the abstract only says POTS and the abstract didn't identify any subgroup that I can see. So don't know! Quote Link to comment Share on other sites More sharing options...
green Posted June 20, 2012 Report Share Posted June 20, 2012 > The symptoms that improved the most included fatigue (55%),That is what I'm looking for! Unfortunately, I'm at 60 mg X 2 a day, and still no benefits. Quote Link to comment Share on other sites More sharing options...
HyperPOTS8 Posted June 28, 2012 Report Share Posted June 28, 2012 The standing Hr improved from an average of 94 to 82 and the DBP improved from 71 to 74.Dr. Sandroni at Mayo told me mestinon only helps POTS pts with low not high BP. Quote Link to comment Share on other sites More sharing options...
hholmes13 Posted June 28, 2012 Report Share Posted June 28, 2012 Well I sure hope I'll be one of those that sees a benefit. I'm currently up to 60mg in the am and 30mg in the afternoon. No benefits so far...but I'm crossing my fingers. I've been lucky that I haven't really had any side effects. The only thing I noticed was that with the increased dose in the morning, my legs feel kind of weak like they can't support me when I'm walking. I'm hoping that will go away. I have a really sensitive stomach and have had zero GI side effects. That was quite a pleasant surprise! Now I just want to try and get functional again!! Quote Link to comment Share on other sites More sharing options...
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