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Date of Award

Spring 2020

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Shannon Diallo MMS, PA-C, CAQ-HM

Abstract

Introduction: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia and orthostatic intolerance which mainly affects young women between the ages of 18-50. Current treatment options occasionally prove ineffective or inadvertently exacerbates symptoms. Therefore, this review analyzes the use of oral stimulants (I) for symptom management (O) in women ages 18-50 with refractory POTS (P) compared to standard medications (C).

Methods: A literature search was conducted through Google Scholar, Clinical Key, and PubMed in November 2018. A total of five articles consisting of various study designs were selected based on publication date, intervention technique, and sample population.

Results: The evidence collected by most of the selected studies demonstrated statistically significant improvement in POTS symptoms with amphetamine treatment. Three studies evaluated the use of methylphenidate, one study evaluated the use of modafinil, and one study evaluated the use of LDX to treat various symptoms associated with POTS. Overall, most of the studies selected showed improved symptoms and return to daily function.

Discussion: Most of the studies found that amphetamines improved symptoms of POTS more than standard treatments. While most of the studies implemented strict inclusion criteria, the validity of the results remains in question due study design flaws.

Conclusion: The results of the current studies are promising; however further research needs to be completed in order to implement amphetamines as a standard of care in the treatment of POTS. The evidence collected from the selected studies remains preliminary in nature and is not currently strong enough to suggest a change in the current treatment guidelines.

Additional Files

References_PICO.pdf (132 kB)
McGrath_Poster.pdf (15233 kB)

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The efficacy of amphetamines in the treatment of postural orthostatic tachycardia syndrome

Introduction: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia and orthostatic intolerance which mainly affects young women between the ages of 18-50. Current treatment options occasionally prove ineffective or inadvertently exacerbates symptoms. Therefore, this review analyzes the use of oral stimulants (I) for symptom management (O) in women ages 18-50 with refractory POTS (P) compared to standard medications (C).

Methods: A literature search was conducted through Google Scholar, Clinical Key, and PubMed in November 2018. A total of five articles consisting of various study designs were selected based on publication date, intervention technique, and sample population.

Results: The evidence collected by most of the selected studies demonstrated statistically significant improvement in POTS symptoms with amphetamine treatment. Three studies evaluated the use of methylphenidate, one study evaluated the use of modafinil, and one study evaluated the use of LDX to treat various symptoms associated with POTS. Overall, most of the studies selected showed improved symptoms and return to daily function.

Discussion: Most of the studies found that amphetamines improved symptoms of POTS more than standard treatments. While most of the studies implemented strict inclusion criteria, the validity of the results remains in question due study design flaws.

Conclusion: The results of the current studies are promising; however further research needs to be completed in order to implement amphetamines as a standard of care in the treatment of POTS. The evidence collected from the selected studies remains preliminary in nature and is not currently strong enough to suggest a change in the current treatment guidelines.