• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

SNRI isn't raising blood pressure

Prefect

Senior Member
Messages
307
Location
Canada
I was put on an SNRI called Fetzima by my doctor 4 days ago who feels all my problems are a mood disorder.

I let her, because I've read SNRI/SSRIs also help with POTS. I also buy the mood disorder part because mood disorders are comorbid with POTS, IBS, all of which I have.

But it's not helping. Even though a side effect is raised blood pressure my BP is still around 90/70 even though my standing pulse is constantly over 100. In fact I feel more dizzy when I stand up now and I'm even more tachycardic now but shockingly my BP is still 90/70.

Are these meds supposed to take time before they help with POTS or is an SNRI (this one has 10 times for affinity for norepinephrine than serotonin) just a bad idea and I should try an SSRI instead. If so which do you recommend that helped you.

Thanks!
 

Snowdrop

Rebel without a biscuit
Messages
2,933
I think desmopressin has been used by many POTS sufferers here to good effect.
And also electrolyte solution with salt. This would be of more benefit I think than Fetzima.

Also with regard to mood disorders I would expect SSRI's would only help depression of an organic origin. If you feel low mood as a result of being ill the best way to treat that is to treat the illness. Improving quality of life will help improve mood.
 

Prefect

Senior Member
Messages
307
Location
Canada
And also electrolyte solution with salt.

I'm not sure I have the hypovolemic type. I've had 6 g of salt with 2 lt of water when I wake up for days, it doesn't seem to help. I urinate it all by 10:30 and my BP stays the same.
 

Prefect

Senior Member
Messages
307
Location
Canada
If you want to raise blood pressure, midodrine might be a better option.

My doctor wouldn't put me on it. She thinks my entire condition is psychosomatic and will only talks SSRI/SNRI, so I'm stuck with those as options, and I've read they truly help people with POTS. I'm shocked it hasn't helped me yet.
 

Prefect

Senior Member
Messages
307
Location
Canada
Also, in addition to my POTS I know for a fact I suffer from a mood disorder. They tend to be comorbid. Even during "remissions" I have panic disorder/agoraphobia.
 

xrayspex

Senior Member
Messages
1,111
Location
u.s.a.
I have hypotension issue but prozac, cymbalta even prilosec and zantac messed with my b/p in such a way as to worsen hypotension or cause what I suspected was intracranial hypotension bouts with bad headaches
I think it was in part because with neurally mediated hypotension if you speed up the heart it lowers b/p further....can't always win taking that sort of route

yea I agree that mood and physical health is all related....I think its unfortunate there can be stigma attached to mood part because mainstream medicine can still have hard time seeing its all related and not necessarily in a behavioral free will way.....who is not going to be in a bit of a lousy mood when cytokines out of control with inflammation
 

boombachi

Senior Member
Messages
392
Location
Hampshire, UK
Liquorice helps me. Not the deglycyrrhized liquorice. If you have a herbal pharmacy near you the herbs are stronger than commercial supplements. Since your GP won't help a herbalist can prescribe other herbs to raise blood pressure and address pots.
 

boombachi

Senior Member
Messages
392
Location
Hampshire, UK
Doesn't it mess with your adrenals? I bought some liquorice tea the other day and then chickened out.

I can't comment on the effect on adrenals as I wouldn't know what to look for. I see a herbalist who makes up medicines for me. It may be she puts something else in to balance it out. We experiment a bit with different things. When liquorice was added I noticed very quickly that I didn't get the chills quite so easily and stamina improved. Also less numbness and carpal tunnel and tendonitis.

I have recently started some new herbs, none of which I can remember names of apart from shativari and I wanted to keep the licquorice, so I will let you know how that goes in a couple of weeks and find out the names. This time she is specifically targetting nervous system.

I am really lucky to have found an experienced herbalist who can tailor the medicine for me specifically. This is really impotant as getting the dosage right. I know not everyone has this luxury so I will share as much as I can with you. I was a bit sceptical at first and it is still just addressing symptoms but I have noticed a big improvement. At the very least migraines, psoriasis, hands going numb, tendonitis and ibs symptoms are under control with a bit more stamina.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
My doctor wouldn't put me on it. She thinks my entire condition is psychosomatic and will only talks SSRI/SNRI, so I'm stuck with those as options, and I've read they truly help people with POTS. I'm shocked it hasn't helped me yet.


Firstly find a new doctor as a doctor like this is bad if you have ME. Once u got a new doctor, start pushing for some of the tests you should have eg tilt table test for POTS. Positive tests can help make sure those disbelieving drs pay more head that your issues are more then just in your head.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
I'm not sure I have the hypovolemic type. I've had 6 g of salt with 2 lt of water when I wake up for days, it doesn't seem to help. I urinate it all by 10:30 and my BP stays the same.

If you do have POTS, just boosting fluid alone and taking salt is usually not enough. you need right meds for the POTS too. The one most used is florinef which helps ones body to hold onto the extra fluids being drunk so they arent just peed out. Also for POTS its 2-3L of fluids usually suggested and cause its a high amount of fluid needed, often electrolyte solutions are the best to be used.

Best to see a specialist for POTS...
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Doesn't it mess with your adrenals? I bought some liquorice tea the other day and then chickened out.

"Licorice is sometimes taken by mouth along with the herbs Panax ginseng and Bupleurum falcatum to improve the function of the adrenal glands, especially in people who have taken steroid drugs long-term. Steroids tend to suppress the activity of the adrenal glands. The adrenal glands produce important hormones that regulate the body's response to stress."

http://www.webmd.com/vitamins-supplements/ingredientmono-881-licorice.aspx?activeingredientid=881

.....................


http://www.webmd.com/vitamins-supplements/ingredientmono-881-licorice.aspx?activeingredientid=881 by this licorice affects MANY drugs