Medication treatments for postural orthostatic tachycardia syndrome, including fludrocortisone, beta blockers, midodrine, and SSRIs, showed some favorable effects across 8 studies (N=499).
Systematic Review (n=499)
Does medication treatment improve outcomes in patients with postural orthostatic tachycardia syndrome?
There is a lack of high-quality data for POTS pharmacotherapy, though limited evidence suggests potential benefits from fludrocortisone, beta blockers, midodrine, and SSRIs.
PURPOSE: Postural orthostatic tachycardia syndrome has been recognized for decades, but treatment is largely based on anecdotal experience and expert opinion. Pharmacologic treatment is inconsistent and unstandardized. We did a systematic review to identify controlled studies from which informed treatment decisions can be made. METHOD: Through a standard systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified all English-language studies of a medication treatment for postural orthostatic tachycardia syndrome that included a comparison or control group and followed outcomes for at least 1 week of treatment. RESULTS: A total of 626 studies were identified by the search criteria, and 8, involving a total of 499 patients, met the criteria. No studies were adequately similar to allow for meta-analysis. Of the identified 8 studies, 2 were randomized controlled trials and 4 had been subjected to peer review. In individual studies, there was some favorable effect with fludrocortisone, beta blockers, midodrine, and selective serotonin reuptake inhibitors. CONCLUSION: There is a paucity of high-quality data about effectiveness of medication in the treatment of postural orthostatic tachycardia syndrome. Nonetheless, 2 randomized trials and 6 other reports show some favorable effects of medication.
Hasan et al. (2020) conducted a systematic review in Postural orthostatic tachycardia syndrome (n=499). Medication treatment (fludrocortisone, beta blockers, midodrine, selective serotonin reuptake inhibitors) vs. Comparison or control group was evaluated on Effectiveness of medication. Medication treatments for postural orthostatic tachycardia syndrome, including fludrocortisone, beta blockers, midodrine, and SSRIs, showed some favorable effects across 8 studies (N=499).