ADHD and POTS

[Pistol]

I would like your opinion ( or knowledge ) on this:  Due to the cognitive deficits occurring in POTS I was seen by a neuropsychologist years ago that diagnosed me with ADHD. Because of symptoms of this being present in childhood she said it was a primary diagnosis, not due to POTS. My brother and sisters ( sisters also were diagnosed with hyperadrenergic POTS in the last few years ) recently were diagnosed with it as well, the physicians said no doubt about it, 150 %.  

According to literature ( I am including the following article ) the ADHD in POTS is AQUIRED and not as prominent. 

https://www.dysautonomiainternational.org/blog/wordpress/cognitive-dysfunction-and-brain-fog-in-pots/

In hindsight my autonomic specialist believes that my POTS was present since childhood as well, I was just able to compensate for it most of my life ( I had obvious symptoms of it in teenage years ). 

The above article was written years ago, since the article they found out that Ritalin ( commonly used for ADHD ) helps POTS symptoms, so I have been on this med for years, with good effects. --- I am now wondering: since in my case ADHD and POTS BOTH run in my family : are they related? Could the ADHD be CAUSED by the POTS ( hyperadrenergic type ) or are they separate issues? Do any of you share symptoms of ADHD along with your POTS diagnosis - or have been diagnosed with both? Do any of you take ADHD meds for your POTS ( Guanfacine, Ritalin etc ). -- 

https://www.heartrhythmalliance.org/files/files/stars/For Clinicians/Methylphenidate POTS.pdf

The above article states this: 

"Based on our observations in this study we conclude that methylphenidate may be a beneficial therapy in POTS patients who fail or are intolerant to first line therapy. A prospectively designed randomized study in future may better define the role this therapy in patients with POTS."

According to this it appears that Ritalin is given for the POTS related cognitive issues, which leads me to believe that MOST POTS patients have ADHD related symptoms? 

I am confused by this ( and I probably shouldn't be b/c it makes no difference in my treatment ). Essentially I am wondering if the egg came before the chicken.  What are your thoughts on this, if you have any? 
 

[RecipeForDisaster]

I take adderall for my Dysautonomia and super fatigue (lack of sleep, due to illness and sleep apnea, too), and it helps me to feel more alive and awake, with a slightly better BP. I have no issues from taking it, and I even skip a day every week to be sure I can function without it. I only take 2.5mg most days which is ridiculously tiny. If I don’t sleep at all, I take 5mg which is what was prescribed. It’s more to help me perfuse than anything.
 

I don’t have ADD/ADHD. I do have trouble thinking the more sick I am, but I think that’s purely perfusion related and distraction from feeling so lousy. When I’m trying not to pass out, that fully occupies my mind.

[Lily]

ADHD is much more than brain fog, so I am not convinced that POTS causes ADHD.  Surely POTS can cause some symptoms that overlap with ADHD, but not all of them. 

I have had ADHD symptoms back as far as toddlerhood.  I was diagnosed in my teens, but nobody thought to try medication until much later.  I didn't have any symptoms consistent with POTS until about 3 years after I started taking Strattera, a non-stimulant ADHD medication.

I recently switched from Strattera to Adderall for ADHD.  Interestingly, I am feeling 100% better POTS-wise.  I do not know if it is because I am no longer taking a norepinepherine reuptake inhibitor (NE was leaking out of the synapses into my blood perhaps?), or if the Adderall is helping my poor deficient veins to constrict properly.  Both are possible.  Adderall has fewer side effects than Strattera, but I liked the 24 hour activity of the Strattera.  I'm learning to deal with it, though.