Medication combos that work for pain and POTS symptoms

[keenly]

I am currecntly using Tramadol for pain and midodrine in morning to keep blood pressure up. I have just tried amytripline for sleep last night, only 5mg. Never been on this many meds before but I have POTS plus 2 venous ulcers right now and can barely cope.

Any combos people use? Sleep/ pain POTS?

 

[DonPepe]

Mestinon

 

[DonPepe]

Mestinon in combo with low dose amisulpride low dose abilify and high dose thiamine is working for me at the moment. Both for pots and pain. And also I’ve experienced an increase in energy that is allowing me to do simple things I couldn’t dream of weeks and months ago. Since I added mestinon and titrated up to 60mg my executive functions have improved a good 35%

 

[Judee]

I used to not recommend PPIs but I've been going through some additional health issues that come with nausea and pain.

Anyway, in the fall of last year I found that the PPIs actually helped me with nausea better than the anti-nausea meds so one day recently when I was experiencing that again, I took Prevacid and was happily surprised when my body pain greatly diminished too.

I'm not saying it would work for everyone. I'm also not sure it does anything for the POTS but thought I'd mention it anyway.

Maybe not a great long term solution but it's helping me so I'm going to stay on them for now.

 

[kangaSue]

Have you tried low dose naltrexone before for pain?

Incidently, do you happen to have iliac vein compression (May Thurner Syndrome which is something that can cause both POTS and venous ulcers (that most typically occur in the left leg)?

 

[kushami]

There has been an article (not a study) that described six patients trying LDN for POTS:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497067/

Three out of six reported a reduction in symptoms that they attributed to LDN. Two discontinued LDN as they felt it was providing no benefit, and one was lost to detailed follow-up.

None reported any major adverse effects, but of course they did not also have ME/CFS.

There is a large clinical trial planned on LDN for POTS:
https://clinicaltrials.gov/study/NCT05363514?term=pots ldn&rank=1