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Which has the least side effects with POTS (esp. cardiac)?  

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Paxil is my wonder drug, but at the same time, I wouldn't recommend that others try it. It has the worst side effects of the SSRIs (weight gain and sexual side effects) and is the hardest to get off of (not an issue for me since I'll be taking it until the day I die.)

If I could do it over again, I'd try Celexa. Old enough to have a generic, and supposed to have fewer bad reactions.


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I can't take any, but my son did well on celexa, till they wanted to go above 20 mg. Effexor was AWFUL for him. It is the only drug he has ever had major problems with. He took paxil for a long time, and had no problems at all getting off it, unlike the effexor he was on for a few weeks. His biggest problem is he seems to develop a tolerance and then they have to switch.

Right now he is on Lexapro. He got nauseated for the first week or so, but seems to be be better. We switched him to taking it at bedtime, so we will see.. It only makes him sick for a few hours, but it's not fun to be nauseated for a few minutes. None of them has affected his sexual function or his heart and he does run a bit on the high side of normal. morgan

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I am prescribed Paroxetine (paxil) by my cardiologist for my POTS symptoms. It does help with the dizziness and tiredness of POTS. HOwever it does have side-effects. When I first started it I felt totally drunk after just one 20mg tablet, the walls and floor were moving and I couldn't walk in a straight line, I also had severe nausea. Those immediate side-effects lessened when I cut to just 10mg daily for the first week and after 2 weeks I was no longer dizzy or nauseous.

The longer term side-effects have been a steady weight gain of 1-2 pounds per month (which I am now attempting to stop/reverse) and a loss of libido.

I'm not taking it for depression but I know others who are and say that it is very effective for treating depressive symptoms. With all medications it is a matter of balancing the pros and the cons before deciding whether to take the med.

I hope you find a med that suits you and you start to feel a bit better soon.


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I'm a "none of the above". My neuro and my headache specialist both recommended cymbalta, which is supposed to be a pain blocker as well as an antidepressant. So far, not much luck with my pain level, but my mood has definitely improved! :)

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