Does Prozac help POTS? (+3 strategies)

In this article, we will answer the query “Does Prozac help POTS?”. We will also explore the role of Prozac in managing the symptoms of POTS and its pharmacological and non-pharmacological management.

Does Prozac help POTS?

Prozac does help with postural orthostatic tachycardia syndrome (POTS). Prozac (Fluoxetine) is an SSRI antidepressant indicated for treating anxiety and depression (1).

Postural orthostatic tachycardia syndrome (POTS) is a diverse autonomic disorder. International societies have defined POTS as a persistent increase in the heart rate of not less than 30 bpm during 10 minutes of standing upright. However, individuals aged 12 to 19 may experience a rise of 40 bpm (2).

In addition to its use in depression, Prozac and other SSRIs like Lexapro, have been found to be helpful in managing the symptoms of postural orthostatic tachycardia syndrome (POTS). 

While Prozac is not specifically prescribed to treat postural orthostatic tachycardia syndrome, some healthcare providers might consider Prozac as a part of a treatment plan for managing certain symptoms associated with POTS.

However, the effectiveness of Prozac or any SSRI in managing POTS symptoms can vary from person to person.

How does Prozac help POTS?

Disturbances in serotonin production and regulation have been proposed as potential contributors to elevated heart rate and blood pressure seen in postural orthostatic tachycardia syndrome (POTS).

The exact mechanism of SSRIs, including Prozac, in managing POTS is not fully known. However, it has been suggested that SSRIs improve the symptoms of orthostatic intolerance by enhancing the nerve stimulation of the vasoconstriction reflex during standing.

What does research suggest?

There is only a limited number of reported cases that support the use of Prozac in POTS. One study suggested that SSRIs, like Prozac, enhance nerve signals that help the body regulate blood flow when standing.

This reduces blood pooling in veins and improves the body’s ability to handle standing up, which can be helpful in managing symptoms for people with POTS (3).

The study also indicated that the combination of SSRI and SNRI has been found beneficial for patients who are experiencing symptoms of POTS. An NRI (nor-epinephrine reuptake inhibitor) such as Bupropion is also beneficial in helping patients with POTS (3).

What are the symptoms of POTS?

The symptoms of postural orthostatic tachycardia syndrome include (4):

  • Lightheadedness
  • Syncope
  • Palpitations
  • Exercise intolerance
  • Anxiety
  • Tremors

These symptoms usually arise when standing but go away when the patient lies down. Yet they can restrict the patient’s capacity to do everyday tasks like bathing, house chores and eating.

POTS symptoms tend to occur more frequently in women after pregnancy, viral infections, fever, trauma or surgery. These symptoms can also be produced due to other conditions like diabetes or alcoholism.

How is POTS managed pharmacologically?

Medications that are used to treat and manage POTS include (3,5):

  • Fludrocortisone
  • Midodrine
  • Methylphenidate
  • Erythropoietin
  • Labetalol

There are no FDA-approved medications for the treatment of POTS (6). However, above mentioned medications have shown improvement in the symptoms of POTS. 

Treatment of POTS requires a multidisciplinary approach using both pharmacological and non-pharmacological interventions. The main goal of pharmacological therapy is to improve symptoms.

How to manage POTS non-pharmacologically?

The following non-pharmacological measures should be taken to manage and improve the POTS symptoms (5):

  • Aerobic exercise for more than 30 minutes a day helps to increase the venous blood flow in the legs.
  • Avoiding the use of medications that worsen the symptoms of POTS, such as ACE inhibitors, calcium channel blockers, diuretics and phenothiazines.
  • To effectively handle POTS symptoms, it is recommended to ensure sufficient fluid intake and consume 3-5 grams of salt daily.
  • Individuals with dysautonomic syncope should use waist-high compression stockings to increase pressure on the calves, thereby reducing the pooling of blood in the veins.

Final words

In my view and the knowledge available, Prozac is not specifically prescribed for POTS. However, SSRIs, like Prozac, may be used to manage symptoms like anxiety or depression that often accompany POTS.

I suggest consulting a healthcare provider to determine the most suitable treatment options for managing POTS effectively.



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