Suggest Treatment For Orthostatic Hypotension

Posted on Wed, 9 Jul 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 9 Jul 2014 Answered on

Wed, 30 Jul 2014 Last reviewed on

Question : My daughter (25 years old) has had orthostatic hypotension for years but it has never affected her too much. In November of last year her symptoms got worse. She is now on 3 doses per day of midodrine and still has low blood pressure problems. I don't understand whY her symptoms have become so severe since nov. And why she has it in the first place. Also, what is the next step if the 3 pills per day don't control it to the degree we would like?

Answered by Dr. Benard Shehu (6 hours later)

Brief Answer:
Find out the real cause first...

Detailed Answer:
Hi there,

I am sorry for the situation your daughter is in.

If I was her caring doctor would try to find out why she is having orthostatic hypotension. Therefore, many other examinations are needed for final conclusions:
- ECG, cardiac echo, Holter monitoring to rule out cardio-vascular problems
- neurological: need to get neurologically tested
- endocrine (metabolic): need to run several blood tests, biochemistry and hormonal profile
- TILT testing

Depending on the tests results, specific treatment will be prescribed.

Meanwhile, I advise to:
- take Advil/caffeine or effedrin if Midodrine is not working
- increase the amount of dietary salt
- wear elastic socks (they are a type of special stocks used in these patients)

Hope it was of help! Wish fast recovery! Do not hesitate to write me back if you have further queries!
Dr.Benard

Above answer was peer-reviewed by : Dr. Vaishalee Punj