TREATMENT DATABASE
Midodrine (Amatine, Proamatine) is an anti-hypotensive agent, that works by causing an increase in blood pressure. It is classed as an alpha-agonist.
Midodrine was developed to treat orthostatic hypotension, a form of orthostatic intolerance (OI) in which a person's blood pressure drops upon standing. The most common cause of orthostatic hypotension is diabetes mellitis. The drug works by acting on alpha-adrenergic receptors in arteries and veins, producing an increase in vascular tone. Unlike beta-blockers, midodrine does not affect cardiac beta-adrenergic receptors. Nor does it cross the blood-brain barrier, which means it has little effect on the central nervous system.
It is used to treat orthostatic intolerance (OI), Postural Orthostatic Tachycardia Syndrome (POTS), vasovagal syndrome (fainting), spinal cord injuries, and dysautonomia caused by Parkinson's disease.
USES IN ME/CFS: Dysautonomia, including OI and POTS is common in ME/CFS patients. A study in 2009 by a group of researchers at Newcastle University in England confirmed that people with ME/CFS not only have lower blood pressure but abnormal diurnal blood pressure regulation. They found that the greater the dysregulation in diurnal blood pressure, the greater the fatigue. The researchers recommended midodrine as a possible treatment.
A number of ME/CFS physicians have used midodrine to treat OI in their patients, including Dr. Klimas, Dr. Rowe, and Dr. Chia.
| Rating | Side Effects | Reason for Treatment | Dosage / Duration | Age | Sex M/F | # of years Ill | Additional Comments | Illness Severity | Date Added |
|---|---|---|---|---|---|---|---|---|---|
| 2 | High blood pressure. Normally I run low, but I was in the 150’s over 90’s to 100’s on Midodrine. | POTS. | 2 month 5mg 1X day | 53 | Female | 4 | I know it works well for others with POTS. | Moderate/Severe | 06/20/18 |
| 1 | HORRIBLE!!! Sick and throwing up all day long everyday I took it | POTS Syndrome. Very high heartbeat anytime I sit up or stand or walk. | 2 week 10 mg (whatever normal starting dose is) 1X day | 39 | Female | 3 | Not worth it! Vomiting never went away the whole 2 weeks I tried it! | Moderate | 10/13/19 |
| 4 | Light headache the first days | POTS , low blood pressure | 3 week 5mg (started with 2,5mg) 3X day | 36 | Female | 1 | The tachycardia improved specially with the 5 mg dose. I recommend starting with 2,5mg progressively | Moderate/Severe | 11/25/20 |
| 5 | Digestive Discomfort and Stomach Aches at full dose (10 mg). Starting at 5 mg and then building to 7.5 mg helped significantly. | POTS/Orthostatic Intolerance | 1 year 5-10 mg 3X day | 24 | Male | 3 | I take 7.5 mg 3x a day now to help with orthostatic intolerance and I don't have nearly the brain fog I had while taking beta blockers. I only take 10 mg when I will be exerting myself at an above average level but getting the right dosage is very important. This drug (combined with Pyridostigmine) has taken me from being bedridden to being functional for at least 6-8 hours per day. | Moderate | 05/20/22 |