Midodrine has worked pretty well for me. I agree that it is just treating the symptoms but, in my case, that's all I can do. It would be great if I could find a doctor to identify and treat some hidden infection (if indeed I have one) but that has not been possible for me. So, until that day comes, I'll take treating the symptoms as the next best thing.
The only side effect I've ever had from midodrine is the prickling feeling on the top of the head. (like goosebumps - something to do with how it affects the hair follicles) That has gone down quite a bit over the years but it still happens once in a while.
As others have said, some people don't do well on this drug. Also, your doctor might recommend that you take your own blood pressure at home for a while just to make sure it doesn't make your BP go to high. Mine is in no danger of that but some people do have this problem.
As far as lying down goes, when I need to rest I lie back in the recliner with my feet up. That way my head and torso are fully supported and resting but it's not lying down flat. My head is still higher than my feet. Then there are those days when I'm feeling much sicker (migraine, flu, or whatever). On those days I just skip the midodrine altogether. It's only helpful for me when I'm trying to be upright. It's definitely not needed (and possibly contraindicated - could make BP rise too high) if you're going to be lying flat most of the time.
My cardiologist is the one who monitors my prescription because my primary care physician said she was not familiar enough with the drug to feel comfortable prescribing it. Are you seeing a cardiologist? Not that they necessarily will know much about orthostatic intolerance - I'm just curious.
There are several threads that talk about midodrine in the sub-forum for orthostatic intolerance (
http://forums.phoenixrising.me/foru...hen-Standing-Orthostatic-Intolerance-POTS-NMH... ) Or you could do a search for midodrine and see what comes up. And I'm sure folks over on the dinet forums have posted about this drug (see
http://forums.dinet.org/ )
Best of luck to you! Let us know if you tried it and whether it helped.