Antidepressants For Pots And/or Mcas

[Jennij]

I've tried searching past posts and can't seem to get the right info....has anyone been prescribed antidepressants for POTS and/or MCAS? If so, which ones work and which ones don't?

[Christy_D]

Doxepin is prescribed for both POTS and MCAS. My son had great results for 6 weeks, a couple of years ago, but then it stopped. It still helps keep some symptoms at bay so he continues to take it. When he has weaned off completely he does worse. Doxepin has antihistamine in it.

[Jennij]

Thanks. My confusion about Doxepin though is isn´t that a tricyclic antidepressant? I thought that those were the type POTS patients should avoid according to the list on the DINET website http://www.dinet.org/what_to_avoid.htm

[corina]

I'm on an SSRI. It keeps my standing hr in control. I have tried to wean off two times but when I do my standing hr goes up again (from 65 seated to about 180 standing) so I'm pretty comfortable being on Paxil as that is what my body needs. I'm on 20mg a day (10mg was helpful but still made my hr go up too much, 20mg does the trick for me).

Hope this helps!

[Darlene]

i m on lexapro. before this med my bp was pretty low. since taking lexapro, my bp is higher, and now i don't feel like i am going to pass out 24/7. lexapro also helps thin the blood, allowing it to flow more freely. i do not like the weight gain from it, and have tried to quit taking it a few times... but when i do, my symptoms get worse. weird how an ssri can help your symptoms. i tried an snri once, but it worsened my tachycardia... the norepinephrine in it i think does that. grubb does suspect mcad... does doxepin have any side effects? lexapro has none except weight gain, and helps my bp.

[jknh9]

I'm on Zoloft (75 mg) and Wellbutrin (37.5 mg). I was previously on 100 mg of Zoloft, but since adding the Wellbutrin I've been able to step off it a little bit. The Zoloft keeps me from fainting and helps to stabilize my blood pressure as it was super low before. The Wellbutrin was added to fight fatigue and help keep my weight steady because the Zoloft was preventing me from losing any weight at all no matter how much I dieted or exercised. I've been pretty happy with this combination, although the Zoloft was AWFUL to get used to.

Edit: By the way, I have POTS and NCS/NMS.

[dpeeps]

Well this is tricky. I was put on SSRI Zoloft before right before being diagnosed. I had been to the ER twice and also to see my Primary Care Doc with Tachycardia, Chest Pain, Light headed, and pre-sycope, GI upset (sound familiar?) , all of whom thought I had Panic Disorder (a more severe form of Anxiety Disorder). I lasted 7 days on the Zoloft. I have never been so sick and mentally unstable in my life!!. I laid on the floor an entire weekend staring at the ceiling. I did not eat for 5 days, had horrible GI issues, muscles jerking uncontrollably, I felt completely on the edge of insanity. I had never been diagnosed with depression, anxiety, or any other mental illness before. It was hands down the single worst experience of my life!. A few weeks after I stopped the Zoloft, I was sent to a Cardiologist who asked me all kinds of questions and then said "I think you might have POTS" I had never heard of POTS before, but now think I had a mild form of it most of my life - maybe since puberty (?). I had a traumatinc brain injury about 18 months prior to the POTS diagnosis. After that, the POTS symptoms grew gradually worse up until the time of diagnosis. Anyway, I had such a terrible experience with the SSRI that I am afraid to take any new medication, such as a Beta-blocker which the Cardo believes will help me. I guess a lot of people do well on SSRIs, but they are not for me. It might have to do with the underlying cause of POTS for each of us.... we have similar/same symptoms, but perhaps different causes...

[Guest Alex]

My experience with citalopram (an SSRI) was almost identical to what dpeeps described above. After 1 week of horrible sx I stopped taking it. 48 h later I felt human again. POTSy, but human.

Dpeeps,

as far as betas go, I won't give you any advice, but you won't know until you try. Keep in mind that most of us require/tolerate only very small amounts of meds in general, so if you ever decide to try a beta you can see how you react to a tiny (homeopathic like) amount and build up from there.

Alex

[weathermandj]

Tramadol (painkiller with SNRI antidepressant properties) works for me.

[Lemons2lemonade]

I take citalopram to a good result but hear that effexor is also good. It controls my HR and reduces panic. I take 10 mg.

[Jennij]

Thanks for all your input. I'm curious to know more about Doxepin. It seems like that's what's most commonly used in MCA issue types. But then again it's a tricyclic which is not recommended for POTS. Any ideas on this one?

[Christy_D]

Doxepin was the first medication that my son was prescribed for his POTS by an autonomic specialist. Every time we increased his dosage, his got more relief. Like I said above, at the maximum dose for him, he did great for 6 weeks and it then abruptly stopped. It still helps to some degree though.

He has also tried Zoloft, Cymbalta, Citalopram in the past. None of them were helpful and at the same time he didn't feel worse on them either. He doesn't usually have bad reactions to medications, they either help or they don't.

[dpeeps]

Thank You Alex (suggestion regarding the Beta-blockers). My cardio actually said he would send me to a compounding pharmacy where they could give me the lowest possible dosage which is not normally available in tablet form. It really ***** to be so sensitive to medication. I always say to myself, "better to just feel crappy Potsy, but myself than to endure side effects". The problem is, they side effects creep up on me and seem to have a cumulative effect. With the Zoloft, I started at 1/4 dose for the first two days, then went up to half dose and started having major problems. Even after I stopped, I swear it was like a week before I started to feel anywhere close to normal again.