Hi everyone, I am a 22 year old male who has been dealing with the symptoms of dysautonomia for about 9 months now. In the spring of this year I developed severe panic and anxiety. I am not sure if it was stress or life events that brought it out, but I was miserable. My heart however, seemed totally fine. Hoping for some relief, I attempted to go on zoloft which I had been on for a short time a few years prior. It had worked great when I was last on it, but this time it was horrible. I developed tremors and my heart went crazy. I developed inappropriate sinus tachycardia which was diagnosed by my cardiologist and was put on toprol xl. My resting heart rate is improved but now I am having pronounced orthostatic issues which I think I have had all along. In the doctor's office yesterday, my laying down bp was 134/89 with a pulse of 100. I was definitely having a little white coat syndrome that accounted at least partially for these numbers. After standing for 3 minutes my blood pressure was 155/100 and my pulse was 134. I don't get dizzy or feel faint but I hate the pounding heart and adrenaline feeling. Exercise or walking up stairs is horrible. It seems like I have hyper pots, but my serum and 24 hour urine catecholamines as of a 2 months ago are normal. Could I just be in total sympathetic overdrive? I also have gi problems (excessive belching mainly) that I never had before. I am obviously not loving the idea of trying an ssri again but am wondering if an snri might be different enough to be worth a try? Thank you for any advice, I am so tired of doctors throwing their hands up and suggesting I go see someone else. Sorry for the italicized text, for someone reason it won't let me change it back. Edit: I should add that it seems like from everything I have read on here, I am having an abnormal response to a normal condition. My stack of test results is about 4 inches thick and nothing is abnormal except my vitamin d is low. I have not had a tilt table test although that will likely happen soon.