Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS)
Schiweck N, et al
Published in Clinical Autonomic Research
Methodology
Systematic literature review screening 3,853 studies and including 45 on non-pharmacological and pharmacological treatment of postural orthostatic tachycardia syndrome, with particular attention to paediatric patients and those with myalgic encephalomyelitis/chronic fatigue syndrome; narrative synthesis without meta-analysis.
Key Findings
From 3,853 studies screened, 45 were included in this review of treatment for postural orthostatic tachycardia syndrome, with a focus on children and people with ME/CFS. The authors report that evidence on POTS therapy is sparse and that large randomised trials of single interventions are still needed. Non-drug measures — compression garments, physical training, salt supplementation and transdermal vagal nerve stimulation — are presented as practical first-line options. Among medicines, ivabradine and beta-blockers showed significant effects across several studies, while midodrine and pyridostigmine improved circulation measures in single studies only.
Conclusions
Non-pharmacological approaches such as the use of compression garments, physical training, salt supplementation and transdermal vagal nerve stimulation could be possible treatment options in POTS.
Limitations
The underlying trials are small, heterogeneous and mostly not randomised, no quantitative pooling was possible, and evidence specific to children and to people with ME/CFS is especially thin.
Related Health Concerns
Study Details
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