Pharmacotherapy for postural tachycardia syndrome
Abstract
Postural tachycardia syndrome (POTS) is a disorder characterized by the presence of orthostatic symptoms (including lightheadedness, palpitations, nausea, dyspnea, and tremulousness) as well as excessive upright tachycardia. POTS predominantly affects women of childbearing age. Treating POTS involves a multi-faceted approach using non-pharmacological and pharmacological interventions. There are no pharmacological treatments that are currently United States Food and Drug Administration (FDA) approved for POTS due to lack of randomized controlled trials. Yet, several medications can improve POTS symptoms and are supported by small prospective studies or retrospective case series. Drugs that are most commonly used for POTS target the following mechanisms 1) blood volume expansion, 2) reduction of heart rate, 3) peripheral vasoconstriction and 4) sympatholysis. Pharmacological approaches can also be used to target specific symptoms including "brain fog," fatigue, sleep, and depression. This review outlines pharmacological approaches for treating POTS and summarizes evidence supporting each treatment approach.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The main limitation of pyridostigmine's use is adverse gastrointestinal effects, which can include diarrhea, cramping, nausea, vomiting, and flatulence.
“The main limitation of pyridostigmine's use is adverse gastrointestinal effects, which can include diarrhea, cramping, nausea, vomiting, and flatulence (70).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [70]
Clonidine is a centrally acting alpha2-adrenoreceptor agonist with an overall sympatholytic effect.
“Centrally acting a2-adrenoreceptor agonist with overall sympatholytic effect.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [64]
Cites
Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013 · see citing works
Self-citationAutoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies
Vernino, S., Low, P. A., Fealey, R. D., Stewart, J. D., Farrugia, G., & Lennon, V. A. (2000) · New England Journal of Medicine · doi:10.1056/nejm200009213431204 · Cited by 674 · see citing works
Cardiac origins of the postural orthostatic tachycardia syndrome
Fu, Q., VanGundy, T. B., Galbreath, M. M., Shibata, S., Jain, M., Hastings, J. L., Bhella, P. S., & Levine, B. D. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.043 · Cited by 329 · see citing works
Postural Tachycardia Syndrome (POTS)
Raj, S. R. (2013) · Circulation · doi:10.1161/circulationaha.112.144501 · Cited by 320 · see citing works
Self-citationRaj, S. R., Biaggioni, I., Yamhure, P. C., Black, B. K., Paranjape, S. Y., Byrne, D. W., & Robertson, D. (2005) · Circulation · doi:10.1161/01.cir.0000160356.97313.5d · Cited by 286 · see citing works
Self-citationDroxidopa for neurogenic orthostatic hypotension
Kaufmann, H., Freeman, R. L., Biaggioni, I., Low, P. A., Pedder, S. C. J., Hewitt, L. A., Mauney, J., Feirtag, M., & Mathias, C. J. (2014) · Neurology · doi:10.1212/wnl.0000000000000615 · Cited by 279 · see citing works
Autoimmune Basis for Postural Tachycardia Syndrome
Li, H., Yu, X., Liles, C., Khan, M., Vanderlinde‐Wood, M., Galloway, A., Zillner, C., Benbrook, A., Reim, S., Collier, D., et al. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.113.000755 · Cited by 255 · see citing works
Self-citationLöbel, M., Grabowski, P., Heidecke, H., Bauer, S., Hanitsch, L. G., Wittke, K., Meisel, C., Reinke, P., Volk, H., Fluge, Ø., et al. (2015) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2015.09.013 · Cited by 246 · see citing works
Raj, S. R., Black, B. K., Biaggioni, I., Paranjape, S. Y., Ramirez, M., Dupont, W. D., & Robertson, D. (2009) · Circulation · doi:10.1161/circulationaha.108.846501 · Cited by 225 · see citing works
Self-citationPediatric Disorders of Orthostatic Intolerance
Stewart, J. M., Boris, J. R., Chelimsky, G., Fischer, P. R., Fortunato, J. E., Grubb, B. P., Heyer, G. L., Jarjour, I. T., Medow, M. S., Numan, M. T., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-1673 · Cited by 222 · see citing works
Hyperadrenergic Postural Tachycardia Syndrome in Mast Cell Activation Disorders
Shibao, C., Arzubiaga, C., Roberts, L. J., Raj, S., Black, B., Harris, P., & Biaggioni, I. (2005) · Hypertension · doi:10.1161/01.hyp.0000158259.68614.40 · Cited by 220 · see citing works
Self-citationEffects of volume loading and pressor agents in idiopathic orthostatic tachycardia
Jacob, G., Shannon, J. R., Black, B., Biaggioni, I., Mosqueda-Garcia, R., Robertson, R. M., & Robertson, D. (1997) · Circulation · doi:10.1161/01.cir.96.2.575 · Cited by 206 · see citing works
Postural tachycardia syndrome – Diagnosis, physiology, and prognosis
Arnold, A. C., Ng, J., & Raj, S. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.02.005 · Cited by 186 · see citing works
Self-citationFu, Q., VanGundy, T. B., Shibata, S., Auchus, R. J., Williams, G. H., & Levine, B. D. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.172262 · Cited by 175 · see citing works
Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome
Raj, S. R., Black, B. K., Biaggioni, I., Harris, P. A., & Robertson, D. (2005) · Circulation · doi:10.1161/circulationaha.104.497594 · Cited by 171 · see citing works
Self-citationSerotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome
Häuser, W., Urrútia, G., Tort, S., Üçeyler, N., & Walitt, B. T. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010292 · Cited by 164 · see citing works
Hypovolemia in syncope and orthostatic intolerance role of the renin-angiotensin system
Jacob, G., Robertson, D., Mosqueda-Garcia, R., Ertl, A. C., Robertson, R. M., & Biaggioni, I. (1997) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)00133-2 · Cited by 164 · see citing works
Clinical Efficacy of Ivabradine in Patients With Inappropriate Sinus Tachycardia
Cappato, R., Castelvecchio, S., Ricci, C., Bianco, E., Vitali-Serdoz, L., Gnecchi-Ruscone, T., Pittalis, M., De Ambroggi, L., Baruscotti, M., Gaeta, M., et al. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.06.031 · Cited by 159 · see citing works
Endurance Exercise Training in Orthostatic Intolerance
Winker, R., Barth, A., Bidmon, D., Ponocny, I., Weber, M., Mayr, O., Robertson, D., Diedrich, A., Maier, R., Pilger, A., et al. (2005) · Hypertension · doi:10.1161/01.hyp.0000156540.25707.af · Cited by 156 · see citing works
Fludrocortisone for the Prevention of Vasovagal Syncope
Sheldon, R., Raj, S. R., Rose, M. S., Morillo, C. A., Krahn, A. D., Medina, E., Talajic, M., Kus, T., Seifer, C. M., Lelonek, M., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.04.030 · Cited by 155 · see citing works
FOUAD, F. M., TADENA-THOME, L., BRAVO, E. L., & TARAZI, R. C. (1986) · Annals of Internal Medicine · doi:10.7326/0003-4819-104-3-298 · Cited by 154 · see citing works
Biaggioni, I., Freeman, R. L., Mathias, C. J., Low, P. A., Hewitt, L. A., & Kaufmann, H. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.04035 · Cited by 145 · see citing works
Rowe, P. C., Calkins, H., DeBusk, K., McKenzie, R., Anand, R., Sharma, G., Cuccherini, B. A., Soto, N., Hohman, P., Snader, S., et al. (2001) · JAMA · doi:10.1001/jama.285.1.52 · Cited by 142 · see citing works
What is brain fog? An evaluation of the symptom in postural tachycardia syndrome
Ross, A. J., Medow, M. S., Rowe, P. C., & Stewart, J. M. (2013) · Clinical Autonomic Research · doi:10.1007/s10286-013-0212-z · Cited by 141 · see citing works
Sleep Disturbances and Diminished Quality of Life in Postural Tachycardia Syndrome
Bagai, K., Song, Y., Ling, J. F., Malow, B., Black, B. K., Biaggioni, I., Robertson, D., & Raj, S. R. (2011) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.28110 · Cited by 134 · see citing works
Self-citationPsychiatric profile and attention deficits in postural tachycardia syndrome
Raj, V, Haman, K. L., Raj, S. R., Byrne, D., Blakely, R. D., Biaggioni, I., Robertson, D., & Shelton, R. C. (2009) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2008.144360 · Cited by 131 · see citing works
Self-citationGeorge, S. A., Bivens, T. B., Howden, E. J., Saleem, Y., Galbreath, M. M., Hendrickson, D., Fu, Q., & Levine, B. D. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2015.12.012 · Cited by 127 · see citing works
Cognitive and psychological issues in postural tachycardia syndrome
Raj, V., Opie, M., & Arnold, A. C. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.03.004 · Cited by 125 · see citing works
Pyridostigmine in the treatment of postural orthostatic tachycardia: a single-center experience
KANJWAL, K., KARABIN, B., SHEIKH, M., ELMER, L., KANJWAL, Y., SAEED, B., & GRUBB, B. P. (2011) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2011.03047.x · Cited by 106 · see citing works
Single centre experience of ivabradine in postural orthostatic tachycardia syndrome
McDonald, C., Frith, J., & Newton, J. L. (2011) · Europace · doi:10.1093/europace/euq390 · Cited by 105 · see citing works
Coffin, S. T., Black, B. K., Biaggioni, I., Paranjape, S. Y., Orozco, C., Black, P. W., Dupont, W. D., Robertson, D., & Raj, S. R. (2012) · Heart Rhythm · doi:10.1016/j.hrthm.2012.05.002 · Cited by 88 · see citing works
Self-citationBlood Volume Perturbations in the Postural Tachycardia Syndrome
Raj, S. R., & Robertson, D. (2007) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e318063c6c0 · Cited by 80 · see citing works
Self-citationFreitas, J., Santos, R., Azevedo, E., Costa, O., Carvalho, M., & Falcão de Freitas, A. (2000) · Clinical Autonomic Research · doi:10.1007/bf02281112 · Cited by 78 · see citing works
Ross, A. J., Ocon, A. J., Medow, M. S., & Stewart, J. M. (2014) · Clinical Science · doi:10.1042/cs20130222 · Cited by 78 · see citing works
Evaluation of postural tachycardia syndrome (POTS)
Goodman, B. P. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.04.004 · Cited by 77 · see citing works
Stewart, J. M., Munoz, J., & Weldon, A. (2002) · Circulation · doi:10.1161/01.cir.0000040999.00692.f3 · Cited by 71 · see citing works
Gordon, V. M., Opfer-Gehrking, T. L., Novak, V., & Low, P. A. (2000) · Clinical Autonomic Research · doi:10.1007/bf02291387 · Cited by 69 · see citing works
Low-dose propranolol and exercise capacity in postural tachycardia syndrome: A randomized study
Arnold, A. C., Okamoto, L. E., Diedrich, A., Paranjape, S. Y., Raj, S. R., Biaggioni, I., & Gamboa, A. (2013) · Neurology · doi:10.1212/wnl.0b013e318293e310 · Cited by 65 · see citing works
Self-citationEffects of Norepinephrine Reuptake Inhibition on Postural Tachycardia Syndrome
Green, E. A., Raj, V., Shibao, C. A., Biaggioni, I., Black, B. K., Dupont, W. D., Robertson, D., & Raj, S. R. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.113.000395 · Cited by 64 · see citing works
Self-citationThe Use of Methylphenidate in the Treatment of Refractory Neurocardiogenic Syncope
Grubb, B. P., KOSINSKI, D. J., Mouhaffel, A., & Pothoulakis, A. (1996) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1996.tb03367.x · Cited by 59 · see citing works
Treatment of postural tachycardia syndrome: a comparison of octreotide and midodrine
Hoeldtke, R. D., Bryner, K. D., Hoeldtke, M. E., & Hobbs, G. (2006) · Clinical Autonomic Research · doi:10.1007/s10286-006-0373-0 · Cited by 57 · see citing works
BENEZET‐MAZUECOS, J., RUBIO, J. M., FARRÉ, J., QUIÑONES, M. Á., SANCHEZ‐BORQUE, P., & MACÍA, E. (2013) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12118 · Cited by 55 · see citing works
A Pilot Randomized Controlled Trial of Dexamphetamine in Patients With Chronic Fatigue Syndrome
Olson, L. G., Ambrogetti, A., & Sutherland, D. C. (2003) · Psychosomatics · doi:10.1176/appi.psy.44.1.38 · Cited by 54 · see citing works
Mallien, J., Isenmann, S., Mrazek, A., & Haensch, C. (2014) · Frontiers in Neurology · doi:10.3389/fneur.2014.00118 · Cited by 52 · see citing works
Melatonin attenuates the sympathetic nerve responses to orthostatic stress in humans
Ray, C. A. (2003) · The Journal of Physiology · doi:10.1111/j.1469-7793.2003.01043.x · Cited by 51 · see citing works
Ruzieh, M., Baugh, A., Dasa, O., Parker, R. L., Perrault, J. T., Renno, A., Karabin, B. L., & Grubb, B. (2017) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-017-0225-y · Cited by 48 · see citing works
Ivabradine in the treatment of postural tachycardia syndrome (POTS), a single center experience
Ruzieh, M., Sirianni, N., Ammari, Z., Dasa, O., Alhazmi, L., Karabin, B., & Grubb, B. (2017) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.13182 · Cited by 46 · see citing works
Gaffney, F. A. (1983) · CHEST Journal · doi:10.1378/chest.83.2_supplement.436 · Cited by 43 · see citing works
Droxidopa in the Treatment of Postural Orthostatic Tachycardia Syndrome
Ruzieh, M., Dasa, O., Pacenta, A., Karabin, B., & Grubb, B. (2017) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000000468 · Cited by 42 · see citing works
Fares, A. (2011) · Journal of Cardiovascular Disease Research · doi:10.4103/0975-3583.85261 · Cited by 41 · see citing works
Melatonin attenuates the sympathetic nerve responses to orthostatic stress in humans
Ray, C. A. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2003.043182 · Cited by 40 · see citing works
Treatment of orthostatic tachycardia with erythropoietin
Hoeldtke, R. D., Horvath, G. G., & Bryner, K. D. (1995) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)80230-7 · Cited by 38 · see citing works
Postural orthostatic tachycardia syndrome and the potential role of mast cell activation
Doherty, T. A., & White, A. A. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.05.001 · Cited by 37 · see citing works
Gaffney, F. A., Lane, L. B., Pettinger, W., & Blomqvist, C. G. (1983) · Chest · doi:10.1378/chest.83.2.436 · Cited by 36 · see citing works
Moak, J. P., Leong, D., Fabian, R., Freedenberg, V., Jarosz, E., Toney, C., Hanumanthaiah, S., & Darbari, A. (2016) · Pediatric Cardiology · doi:10.1007/s00246-015-1274-6 · Cited by 34 · see citing works
Erythropoietin in the Treatment of Postural Orthostatic Tachycardia Syndrome
Kanjwal, K., Saeed, B., Karabin, B., Kanjwal, Y., Sheikh, M., & Grubb, B. P. (2012) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e3181ef621a · Cited by 34 · see citing works
Melatonin reduces tachycardia in postural tachycardia syndrome: a randomized, crossover trial
Green, E. A., Black, B. K., Biaggioni, I., Paranjape, S. Y., Bagai, K., Shibao, C., Okoye, M. C., Dupont, W. D., Robertson, D., & Raj, S. R. (2014) · Cardiovascular Therapeutics · doi:10.1111/1755-5922.12067 · Cited by 33 · see citing works
Self-citationFludrocortisone improves nausea in children with orthostatic intolerance (OI)
Fortunato, J. E., Shaltout, H. A., Larkin, M. M., Rowe, P. C., Diz, D. I., & Koch, K. L. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0130-x · Cited by 31 · see citing works
Acute volume loading and exercise capacity in postural tachycardia syndrome
Figueroa, R. A., Arnold, A. C., Nwazue, V. C., Okamoto, L. E., Paranjape, S. Y., Black, B. K., Diedrich, A., Robertson, D., Biaggioni, I., Raj, S. R., et al. (2014) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00367.2014 · Cited by 31 · see citing works
Self-citationTreatment of autonomic neuropathy, postural tachycardia and orthostatic syncope with octreotide LAR
Hoeldtke, R. D., Bryner, K. D., Hoeldtke, M. E., & Hobbs, G. R. (2007) · Clinical Autonomic Research · doi:10.1007/s10286-007-0436-x · Cited by 30 · see citing works
Kpaeyeh, J., Mar, P. L., Raj, V., Black, B. K., Arnold, A. C., Biaggioni, I., Shibao, C. A., Paranjape, S. Y., Dupont, W. D., Robertson, D., et al. (2014) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000221 · Cited by 29 · see citing works
Self-citationUse of Octreotide in the Treatment of Refractory Orthostatic Intolerance
Kanjwal, K., Saeed, B., Karabin, B., Kanjwal, Y., & Grubb, B. P. (2012) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e3181e28156 · Cited by 26 · see citing works
Kanjwal, K., Saeed, B., Karabin, B. L., Kanjwal, Y., & Grubb, B. P. (2010) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e3181dd21d2 · Cited by 26 · see citing works
Sleep disorders in patients with postural tachycardia syndrome
Miglis, M. G., Muppidi, S., Feakins, C., Fong, L., Prieto, T., & Jaradeh, S. (2016) · Clinical Autonomic Research · doi:10.1007/s10286-015-0331-9 · Cited by 25 · see citing works
Ivabradine in Postural Orthostatic Tachycardia Syndrome: Preliminary Experience in Children
Donne, G. D., Rosés‐Noguer, F., Till, J. A., Salukhe, T. V., Prasad, S. K., & Daubeney, P. E. F. (2017) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-017-0248-x · Cited by 25 · see citing works
Young, J. L. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2012.09.007 · Cited by 23 · see citing works
Beneficial Effects of Dextro‐Amphetamine in the Treatment of Vasodepressor Syncope
Susmano, A., Volgman, A. S., & Buckingham, T. A. (1993) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1993.tb01708.x · Cited by 23 · see citing works
Pengo, M. F., Higgins, S., Drakatos, P., Martin, K., Gall, N., Rossi, G. P., & Leschziner, G. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2015.08.003 · Cited by 21 · see citing works
Long-term methylphenidate intake in chronic fatigue syndrome
Blockmans, D., & Persoons, P. (2016) · Acta Clinica Belgica · doi:10.1080/17843286.2016.1200816 · Cited by 21 · see citing works
Bagai, K., Peltier, A. C., Malow, B. A., Diedrich, A., Shibao, C. A., Black, B. K., Paranjape, S. Y., Orozco, C., Biaggioni, I., Robertson, D., et al. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.5806 · Cited by 17 · see citing works
Self-citationMiglis, M. G., & Barwick, F. H. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.05.002 · Cited by 15 · see citing works
Prospects for Droxidopa in Neurogenic Orthostatic Hypotension
Ross, A. J., & Stewart, J. M. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.04204 · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352 · see citing works
Vernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102828 · Cited by 304 · see citing works
Self-citationJohansson, M., Ståhlberg, M., Runold, M., Nygren-Bonnier, M., Nilsson, J., Olshansky, B., Bruchfeld, J., & Fedorowski, A. (2021) · JACC: Case Reports · doi:10.1016/j.jaccas.2021.01.009 · Cited by 193 · see citing works
Postural orthostatic tachycardia syndrome as a sequela of COVID-19
Ormiston, C. K., Świątkiewicz, I., & Taub, P. (2022) · Heart Rhythm · doi:10.1016/j.hrthm.2022.07.014 · Cited by 125 · see citing works
Kucharik, A. H., & Chang, C. (2020) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-019-08755-8 · Cited by 122 · see citing works
Taub, P. R., Zadourian, A., Lo, H. C., Ormiston, C. K., Golshan, S., & Hsu, J. C. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.12.029 · Cited by 122 · see citing works
Postural orthostatic tachycardia syndrome: mechanisms and new therapies
Mar, P. L., & Raj, S. R. (2020) · Annual Review of Medicine · doi:10.1146/annurev-med-041818-011630 · Cited by 122 · see citing works
Self-citationPreparing for the long-haul: Autonomic complications of COVID-19
Larsen, N. W., Stiles, L. E., & Miglis, M. G. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102841 · Cited by 90 · see citing works
Blitshteyn, S., Whiteson, J. H., Abramoff, B. A., Azola, A. M., Bartels, M. N., Bhavaraju-Sanka, R. K., Chung, T., Fleming, T. K., Henning, E., Miglis, M. G., et al. (2022) · PM&R · doi:10.1002/pmrj.12894 · Cited by 79 · see citing works
Carmona-Torre, F., Mínguez‐Olaondo, A., López-Bravo, A., Tijero, B., Grozeva, V., Walcker, M., Azkune-Galparsoro, H., de Munaín, A. L., Alcaide, A. B., Quiroga, J. A., et al. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.886609 · Cited by 71 · see citing works
Postural orthostatic tachycardia syndrome in children and adolescents
Boris, J. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.05.004 · Cited by 58 · see citing works
Long COVID: Complications, Underlying Mechanisms, and Treatment Strategies
Zadeh, F. H. (2023) · Archives of Microbiology & Immunology · doi:10.26502/ami.93650103 · Cited by 34 · see citing works
Mechanisms and management of gastrointestinal symptoms in postural orthostatic tachycardia syndrome
Tu, Y., Abell, T. L., Raj, S. R., & Mar, P. L. (2020) · Neurogastroenterology & Motility · doi:10.1111/nmo.14031 · Cited by 26 · see citing works
Self-citationPostural orthostatic tachycardia syndrome and migraine: A narrative review
Mueller, B. R., & Robinson‐Papp, J. (2022) · Headache The Journal of Head and Face Pain · doi:10.1111/head.14365 · Cited by 23 · see citing works
Deng, X., Zhang, Y., Liao, Y., & Du, J. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00460 · Cited by 23 · see citing works
Re: ‘Post-COVID-19 chronic symptoms’ by Davido et al.
Miglis, M. G., Goodman, B. P., Chémali, K. R., & Stiles, L. E. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2020.08.028 · Cited by 20 · see citing works
Cheng, A. L., Anderson, J., Didehbani, N., Fine, J. S., Fleming, T. K., Karnik, R., Longo, M. T., Ng, R., Re’em, Y., Sampsel, S., et al. (2023) · PM&R · doi:10.1002/pmrj.13085 · Cited by 18 · see citing works
Zhang, Q., Xu, B., & Du, J. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00525 · Cited by 18 · see citing works
Treatment of Postural Orthostatic Tachycardia Syndrome With Medication: A Systematic Review
Hasan, B., Almasri, J., Marwa, B. M., Klaas, K. M., & Fischer, P. R. (2020) · Journal of Child Neurology · doi:10.1177/0883073820948679 · Cited by 17 · see citing works
Snapper, H., & Cheshire, W. P. (2022) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.102951 · Cited by 17 · see citing works
Dysautonomia and Headache in the Pediatric Population
Wig, R., & Oakley, C. B. (2019) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13659 · Cited by 16 · see citing works
Ghazal, M., Akkawi, A. R., Fancher, A. J., Oundo, E., Tanzeem, H., Sajjad, L., & Briasoulis, Α. (2024) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2024.102977 · Cited by 14 · see citing works
Orthostatic Intolerance in Children With Long COVID Utilizing a 10-Minute Passive Standing Test
Morrow, A. K., Villatoro, C., Kokorelis, C., Rowe, P. C., & Malone, L. A. (2024) · Clinical Pediatrics · doi:10.1177/00099228241272053 · Cited by 13 · see citing works
Wu, W. K. K., & Ho, V. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1379646 · Cited by 14 · see citing works
Spahic, J. M., Ricci, F., Aung, N., Hallengren, E., Axelsson, J., Hamrefors, V., Melander, O., Sutton, R., & Fedorowski, A. (2020) · BMC Cardiovascular Disorders · doi:10.1186/s12872-020-01465-6 · Cited by 13 · see citing works
Postural orthostatic tachycardia syndrome: pathophysiology, management, and experimental therapies
Narasimhan, B., Aggarwal, D., Satish, P., Kantharia, B. K., & Aronow, W. S. (2022) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2022.2121697 · Cited by 12 · see citing works
Kesserwani, H. N. (2020) · Cureus · doi:10.7759/cureus.10881 · Cited by 12 · see citing works
Tsuchida, T., Ishibashi, Y., Inoue, Y., Ishizuka, K., Katayama, K., Hirose, M., Nakagama, Y., Kido, Y., Akashi, Y. J., Otsubo, T., et al. (2023) · Journal of General and Family Medicine · doi:10.1002/jgf2.670 · Cited by 11 · see citing works
Pearson, R., Sheridan, C. A., Kang, K., Brown, A., Baham, M., Asarnow, R. F., Giza, C. C., & Choe, M. C. (2022) · Child Neurology Open · doi:10.1177/2329048x221082753 · Cited by 11 · see citing works
Wilson, G. N. (2019) · Journal of Biosciences and Medicines · doi:10.4236/jbm.2019.76010 · Cited by 10 · see citing works
Shabtaie, S. A., Witt, C. M., & Asirvatham, S. J. (2021) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14942 · Cited by 11 · see citing works
The Postural Tachycardia Syndrome (PoTS) Bladder—Urodynamic Findings
Walker, N. F., Gall, R., Gall, N. P., Feuer, J., Harvey, H., & Taylor, C. (2021) · Urology · doi:10.1016/j.urology.2021.02.028 · Cited by 9 · see citing works
Steinberg, R. S., Dicken, W., & Cutchins, A. C. (2023) · US Cardiology Review · doi:10.15420/usc.2022.35 · Cited by 9 · see citing works
Pozzi, A. T. D., Enechukwu, M., & Blitshteyn, S. (2019) · BMJ Case Reports · doi:10.1136/bcr-2019-229824 · Cited by 9 · see citing works
Headache disorders in patients with Ehlers-Danlos syndromes and hypermobility spectrum disorders
Mehta, D., Simmonds, L., Hakim, A. J., & Matharu, M. S. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1460352 · Cited by 8 · see citing works
Junghans-Rutelonis, A. N., Postier, A. C., Warmuth, A., Schwantes, S. A., & Weiss, K. (2019) · Journal of Pain Research · doi:10.2147/jpr.s194391 · Cited by 8 · see citing works
Peebles, K. C., Jacobs, C., Makaroff, L., & Pacey, V. (2024) · Autonomic Neuroscience · doi:10.1016/j.autneu.2024.103156 · Cited by 8 · see citing works
Morse, A. M., Bogan, R., Roy, A., & Thorpy, M. J. (2024) · Neurology and Therapy · doi:10.1007/s40120-024-00607-8 · Cited by 7 · see citing works
Functional status in postural tachycardia syndrome
Rich, E. M., Vas, A., Parsons, T. D., Krone, R. D., & Goodman, B. P. (2021) · British Journal of Occupational Therapy · doi:10.1177/03080226211031807 · Cited by 7 · see citing works
Postural Orthostatic Tachycardia Syndrome (POTS): A Frequently Missed Diagnosis
George, A., & Winters, B. A. (2022) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2022.08.022 · Cited by 7 · see citing works
Bourne, K. M., Nerenberg, K. A., Stiles, L. E., Shibao, C. A., Okamoto, L. E., Garland, E. M., Gamboa, A. C., Peltier, A., Diedrich, A., Biaggioni, I., et al. (2023) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17437 · Cited by 7 · see citing works
Self-citationThe Clinical Relevance of Mast Cell Activation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Rohrhofer, J., Ebner, L., Schweighardt, J., Stingl, M., & Untersmayr, E. (2025) · Diagnostics · doi:10.3390/diagnostics15222828 · Cited by 6 · see citing works
Go, S., Yamanaka, G., Kasuga, A., Kanou, K., Takamatsu, T., Takeshita, M., Morishita, N., Morıchı, S., Ishida, Y., Oana, S., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9124125 · Cited by 6 · see citing works
Postural Orthostatic Tachycardia Syndrome as a Manifestation of Post-COVID-19 Syndrome
Trisvetova, E. L. (2022) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2022-04-11 · Cited by 8 · see citing works
Petracek, L. S., Eastin, E. F., Rowe, I. R., & Rowe, P. C. (2022) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-022-00529-8 · Cited by 6 · see citing works
He, L., Wang, J., Liu, Y., Dong, W., Yang, H., Luo, Y., Xiang, T., & Luo, L. (2018) · Neurological Research · doi:10.1080/01616412.2018.1508548 · Cited by 6 · see citing works
Salt: The paradoxical philosopher's stone of autonomic medicine
Cheshire, W. P. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102895 · Cited by 6 · see citing works
Mitra, K., Kunte, S. A., Taube, S., Tian, W. M., Richardson, E. S., Frazier‐Mills, C. G., & Fudim, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13237304 · Cited by 5 · see citing works
Fan, S.-J., Cui, Y., Liao, Y., & Jin, H.-F. (2023) · Children · doi:10.3390/children10071093 · Cited by 6 · see citing works
Heart rate regulation in patients with anorexia nervosa
Baumann, C., Buchhorn, R., & Willaschek, C. (2019) · doi:10.31487/j.pdr.2019.01.003 · Cited by 3 · see citing works
Abdominal Compression as a Treatment for Postural Tachycardia Syndrome
Miller, A. J., & Bourne, K. M. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.120.017610 · Cited by 4 · see citing works
Self-citationTreatment Updates in Postural Tachycardia Syndrome
Goodman, B. P. (2020) · Current Treatment Options in Neurology · doi:10.1007/s11940-020-00643-3 · Cited by 3 · see citing works
COVID-19-Induced Postural Orthostatic Tachycardia Syndrome and Dysautonomia
Minhas, R., & Bharadwaj, A. S. (2023) · Cureus · doi:10.7759/cureus.40235 · Cited by 4 · see citing works
Postural orthostatic tachycardia syndrome (POTS) occurring during treatment for breast cancer
Babra, D., Youn, S., & Devendra, S. (2021) · BMJ Case Reports · doi:10.1136/bcr-2021-242472 · Cited by 3 · see citing works
Evaluation of diseases complicating long COVID : A retrospective chart review
Tsuchida, T., Hirose, M., Fujii, H., Hisatomi, R., Ishizuka, K., Inoue, Y., Katayama, K., Nakagama, Y., Kido, Y., Matsuda, T., et al. (2024) · Journal of General and Family Medicine · doi:10.1002/jgf2.716 · Cited by 2 · see citing works
Mitra, K., Kunte, S. A., Taube, S., Sankarlinkam, S., Mohamed, L., Adodo, E., Wu, K. A., Green, C. L., Fudim, M., & Richardson, E. S. (2025) · Frontiers in Physiology · doi:10.3389/fphys.2025.1621617 · Cited by 2 · see citing works
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
Rowe, P. C. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-75608-2.00200-7 · Cited by 2 · see citing works
Treatment of hemodynamic orthostatic dizziness/vertigo
Kim, H. A. (2024) · Research in Vestibular Science · doi:10.21790/rvs.2024.017 · Cited by 1 · see citing works
Approach to Postural Orthostatic Tachycardia Syndrome
Robbins, N. M., Golden, E. P., Freeman, K. J., Bhavaraju-Sanka, R. K., Snapper, H., & Cook, G. A. (2026) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000200620 · Cited by 1 · see citing works
Documento de posición COVID-19 y corazón
Tajer, C. D., Kazelián, L. R., Pereiro, S. M., Gagliardi, J., D'Imperio, H. A., & Prat, M. R. (2021) · Revista Argentina de Cardiología · doi:10.7775/rac.es.v89.s6 · Cited by 1 · see citing works
Garonzi, M. P. (2022) · L'Espace Politique · doi:10.4000/espacepolitique.10568
Management of Postural Orthostatic Tachycardia Syndrome: A Canadian Approach
Hussein, M. T. E., & Hewko, A. (2024) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2024.105258 · Cited by 1 · see citing works
Pregnancy and Postural Tachycardia Syndrome
Borlase, D., & Nelson‐Piercy, C. (2020) · Springer eBooks · doi:10.1007/978-3-030-54165-1_37 · Cited by 1 · see citing works
Clinical Aspects of Paediatric PoTS
Fischer, P. R., Kavi, L., & Whitehouse, W. P. (2020) · Springer eBooks · doi:10.1007/978-3-030-54165-1_36 · Cited by 1 · see citing works
Fedorowski, A., Hamrefors, V., & Ricci, F. (2020) · Orthostatic Hypotension in Older Adults · doi:10.1007/978-3-030-62493-4_13 · Cited by 3 · see citing works
Lim, P. B. (2020) · Springer eBooks · doi:10.1007/978-3-030-54165-1_30 · Cited by 1 · see citing works
Medication in PoTS: An Overview
Gall, N. P. (2020) · Springer eBooks · doi:10.1007/978-3-030-54165-1_27
Seance du 22 fevrier 1930. Examen philosophique du scoutisme
Rimaud, J., Goblot, F., Rimaud, M., Valdant, M. L. G., François, M., Beygbeder, M., Monod, M. J., Dinner, M., Anziani, M., & Bourgarel, M. (1930)
Clinical and autonomic characteristics in patients with postural tachycardia syndrome
Kim, D. J., Kim, J., & Kang, S. (2019) · Journal of Medicine and Life Science · doi:10.22730/jmls.2019.16.3.96
Updates in postural tachycardia syndrome
Moon, J. (2021) · Annals of Clinical Neurophysiology · doi:10.14253/acn.2021.23.1.1
VanderPluym, J. H., Chadehumbe, M. A., & Pietris, N. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-83005-8.00023-9
Petracek, L. S., Eastin, E. F., Rowe, I. R., & Rowe, P. C. (2022) · Research Square · doi:10.21203/rs.3.rs-1471484/v1
Petracek, L. S., Eastin, E. F., Rowe, I. R., & Rowe, P. C. (2022) · Research Square · doi:10.21203/rs.3.rs-1471484/v2
Treatment of long COVID complicated by postural orthostatic tachycardia syndromePreprint
Tsuchida, T., Ishibashi, Y., Inoue, Y., Ishizuka, K., Katayama, K., Hirose, M., Nakagama, Y., Kido, Y., Akashi, Y. J., Otsubo, T., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-2885209/v1
Table A-2 Summary of Nutrient Functions in HSD and EDS
Guedry, S. E. (2023) · Figshare · doi:10.6084/m9.figshare.22260316
Sinus Tachycardias: Inappropriate Sinus Tachycardia and Postural Orthostatic Tachycardia Syndrome
Talati, A., Uppal, J., Sheldon, R. S., & Raj, S. R. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00016-9
Self-citationDziedzic, A., Furtak, D., Grela, W., Niewiadomska, J., Głogowska, P., Tulej, D., Marciniuk, D., Gniaź, N., Górska, A., & Marko, N. (2024) · Journal of Education Health and Sport · doi:10.12775/jehs.2024.71.56193
Conditions Associated with Vestibular Migraine in Pediatric Patients
Jenks, C. M., & Brodsky, J. R. (2025) · Springer eBooks · doi:10.1007/978-981-96-2167-5_7
Gabriel, A. S., Tsai, T.-Y., Reátegui-Rivera, C. M., Rocco, P., Smiley, A., Powers, C., Brown, J. P., & Finkelstein, J. (2025) · Europe PMC (PubMed Central)
Chaudhury, D., Atia, N., Obiechina, N., Gill, A., Michael, A., & Sampathy, K. (2025) · Cureus · doi:10.7759/cureus.97581
Rich, E. M., Vas, A., Evetts, C. L., Kaplan-Smith, G., & Goodman, B. P. (2025) · Neurorehabilitation · doi:10.1177/10538135251395291
Droxidopa in Critical Care: A Systematic Review of an Emerging Off‐Label Practice
Valladares, C., Batista, F. V., Faltas, M., Menteyas, M., & Chiapaikeo-Poco, K. (2025) · Critical Care Research and Practice · doi:10.1155/ccrp/4830160
Medic Spahic, J., Ricci, F., Aung, N., Hallengren, E., Axelsson, J., Hamrefors, V., Melander, O., Sutton, R., & Fedorowski, A. (2020) · Figshare · doi:10.6084/m9.figshare.12177873
Mauriello, D., Mitchell, B., & Klaas, K. M. (2026) · Pediatric Annals · doi:10.3928/19382359-20260112-04
Barr, J., Marsden, L., Dassanayake, T., Almutairi, N. A., Mckeever, V., Gaber, T., Tarrant, R., Godfrey, B., Witton, S., & Sivan, M. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15072510
Arjoonsingh, A., & Haines, J. M. (2026) · Veterinary Record Case Reports · doi:10.1002/vrc2.70431
Autonomic Assessment and Management in Sports-Related Concussion
Vanood, A., & Arca, K. N. (2026) · Neurologic Clinics · doi:10.1016/j.ncl.2026.05.002
Shinno, K., Iijima, H., Ishitsuka, K., Inoue, N., Hashimoto, Y., Nagai, A., Kamimaki, I., & Nagamitsu, S. (2026) · BioPsychoSocial Medicine · doi:10.1186/s13030-026-00363-1
Kumar, V., Qadri, S. H., da Silva, A. B. N., Malaj, A., Qadri, S. F., Wajeeha, F., Kasina, P., Jumani, M., & Muhammad, H. (2026) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000001823
Headache in patients with joint hypermobility
Oliveira, W. S., Hoffmann, J., Jácomo, A. A. E., Martins, R. O., Barbosa, R. H. A., & Peres, M. F. P. (2026) · Cephalalgia · doi:10.1177/03331024261477381
Pandey, K., Pandey, P., Panday, A., Khanal, S., & Dasari, T. W. (2026) · Autonomic Neuroscience · doi:10.1016/j.autneu.2026.103497
Huang, I. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-23516-0.00127-6
- Authors
- Miller, A. J., & Raj, S. R.
- Affiliations
- Pennsylvania State University (US)
- University of Calgary (CA)
- Corresponding author
- Raj, Satish R.
- Venue
- Autonomic Neuroscience
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 215
- Pages
- 28-36
- ISSN
- 1566-0702 (ISSN-L)
- OpenAlex
- W2801712792
- Semantic Scholar
- 82023133c46095db0ce1baa865990f64315a37c3
- Cited by
- 91
- References
- 71
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 12 · 2023: 8 · 2022: 14 · 2021: 12 · 2020: 15 · 2019: 9 · 2018: 3
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Autonomic Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (MOP142426)
- Cardiac Arrhythmia Network of Canada (SRG-15-P01-001, SRG-17-P27-001)
- National Institutes of Health (UL1 TR000445)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, pharmacotherapy, orthostatic intolerance, blood volume expansion, heart rate reduction, peripheral vasoconstriction, sympatholysis, brain fog, fatigue, sleep, depression, non-pharmacological treatment
- MeSH terms
- Saline Solution, Autonomic Agents, Cardiovascular Agents, Erythropoietin, Humans, Sodium Chloride, Antidiuretic Agents, Postural Orthostatic Tachycardia Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
