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The use of Midodrine in Treating Dysautonomia: A User's Guide

If you or a loved one is suffering from dysautonomia, you are not alone in facing the challenges it brings. Dysautonomia can disrupt daily life with a wide range of symptoms. However, with the combined use of medication and lifestyle changes, symptoms can become more manageable.


What is dysautonomia?

Before we get into midodrine, it's essential to understand dysautonomia. Dysautonomia is an umbrella term for health conditions related to the autonomic nervous system. The term "autonomic" means ”self-governing,” which means it controls things you don't have to think about. This covers a wide range of bodily functions, such as breathing, digestion, heart rate, blood pressure, body temperature, sweating, and much more.


How midodrine Works

Midodrine is a medication that belongs to a class of drugs called alpha-1 adrenergic agonists. By activating alpha-1 receptors in the blood vessels, it leads to constriction or narrowing, this results in elevated blood pressure and aids in:


  • Counteracting orthostatic hypotension: When you stand up, your body's natural response is to increase blood pressure to maintain blood flow to the brain. Midodrine helps to stimulate this response, reducing the likelihood of fainting.

  • Increased blood volume: By constricting blood vessels, midodrine increases blood volume and thereby increases blood pressure.

  • Increase cardiac output: Midodrine also increases the heart's pumping efficiency, which further contributes to increased blood pressure.


Dosage

Midodrine doses start at 2.5 mg three times a day. This can be increased to 5-7.5 mg if needed.


Midodrine is taken every 4 hours.


Sometimes midodrine is prescribed to be used "as required" if patients don't continuously have symptoms, for example, if patients have stressors such as an infection or during the monthly period cycle.


If you have varied blood pressure, you will need to take a blood pressure test 30 minutes before you use midodrine. The blood pressure should be below 135 / 85.


Why is midodrine used when treating Dysautonomia?

For individuals with Dysautonomia, particularly Postural Orthostatic Tachycardia Syndrome (POTS), managing low blood pressure-related symptoms can be a daily challenge. Midodrine can help stabilize blood pressure, reducing the frequency and severity of these symptoms, providing relief and allow individuals to regain control over their daily lives.


Common Side effects

Midodrine can cause a tingling in the scalp and on hair follicles due to its constricting of blood vessels.


Midodrine can affect the bladder, resulting in the retention of urine. Symptoms may include difficulty starting to urinate or changes in how often you need to go.



Considerations Before Taking midodrine

Before incorporating midodrine into your dysautonomia treatment plan, consult a healthcare provider to discuss the medication's suitability, potential side effects, and dosage adjustments tailored to your specific needs.


Conclusion

In conclusion, midodrine can be a valuable addition to the treatment plan for individuals with Postural Orthostatic Tachycardia Syndrome (POTS) or Dysautonomia. By increasing blood pressure and reducing orthostatic intolerance, midodrine can help alleviate symptoms such as dizziness, lightheadedness, and fatigue, allowing individuals to lead more active and comfortable lives.


 

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