Brief Answer:
Atenolol should be stopped, do as directed rest

Detailed Answer:
Thank you for asking!
Thank you for asking!
I understand the trouble with posture intolerance and associated with tachycardia, headache, palpitation, sweating, nausea and near syncope with any posture change from sitting to standing.Now the management depends on the type, whether primary or secondary, and there are non-pharmacological and pharmacological options we all are gonna discuss that.
Here is complete description of what pots is .POTS is defined as orthostatic intolerance associated with tachycardia exceeding 120 beats per minute or an increase in the heart rate of 30 beats per minute from baseline within 10 minutes of changing the posture from a lying to standing position, in the absence of long-term chronic diseases and medications that affect the autonomic or vascular tone. There is no drop in blood pressure; it may even rise in the upright posture. Patients experience symptoms such as headache, nausea, tremors, sweating, palpitation and near syncope.
failure of peripheral vascular resistance to increase sufficiently in response to orthostatic stress, and, consequently, venous pooling occurs in the legs resulting in decreased venous return to the heart. This is compensated for by an increase in heart rate and inotropy.
The most common primary form of POTS is called the 'partial dysautonomic' form and i believe you have this type.
POTS is mostly followed by viral infections, trauma, surgery and after pregnancy.
Lets discuss the management.
1)If you are using any of the following medicines then abruptly discontinue them.
You are using atenolol and that itself causes and worsens POTS so discontinue it and start a more friendly antihypertensive.
Alpha blockers
Beta blockers
Gangion-blocking agents
Angiotensin-converting enzyme (ACE) inhibitors
Calcium channel blockers
Nitrates
Diuretics
Monoamine oxidase inhibitors
Tricyclic antidepressants
Phenothiazines
Ethanol
Opiates
Sildenafil citrate
2)Avoid Dehydration, take plenty of fluids.At least two litres a day.
3)Avoid alcohol
4)Keep salt intake to (3–5 grams/day)
5)Do Aerobic exercise of the lower extremities to augment the skeletal muscle pumps , it will help.
6)Use compression hose extending up to the waist.
7)Discuss the following meds with your doctor and let them dcide what is best for you.
Exercise
Erythropoletin
Hydration + increase salt intake
Octerotide
Fludrocortisone
Labetalol
Midodrine
Clonidine
Methylphenidate
Bupropion
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and noradrenaline reuptake inhibitor (SNRI)
Get in touch with your neurologist to sort out the type of the POTS with some work up like Hyperadrenergic pots, or secondary due to a cause. If you are young and have a POTS after some trauma like surgery or viral infection or pregnancy then it will resolve in 2 to 5 years maximum. If it comes up to be hyperadrenergic then you may need lifelong treatment.Get to your neurologist and stay in touch with them.Let them decide what is best for you.
Take good care and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan

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Brief Answer:
Labetalol

Detailed Answer:
Thank you for asking!
Yes labetalol is advised and recommended..Atenolol even at the slightest dosages does that. Further management of POTS depends on the etiology and cause of it. Seek a neurologist and let them help you with it.
Take care

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Brief Answer:
No not only, reflex tachycardia, clonidine

Detailed Answer:
Thank you for asking!
No beta blockers are not the only thing and contra indicated except labetalol. This is a reflex tachycardia and ganglion blockers like clonidine does that very well.. Discuss all the mentioned medicines we talked about with your neurologist and they will help you with alternative.calcium channel blockers and sotalol can also reduce the heart rate.
I hope it helps.
Take are

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Brief Answer:
Reflex to POTS

Detailed Answer:
Thank you for getting back to me!
Reflex tachycardia is the response of heart to compensate the low volume input to the heart from the body due to POTS while posture change from lying down to sitting or sitting to standing or lying to standing. Blood pools in peripheries and heart does not get enough thus compensates the stroke volume by beating at a faster pace and this is called reflex tachycardia. This reflex tachycardia needs ganglion blockers and not atenolol etc. You should discuss the options i provided in first answer with your doctor.
Hope for the best and good luck.
S Khan

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Brief Answer:
most likely

Detailed Answer:
Thank you for asking!
As i mentioned beta blockers cause this and should not be used except labetalol and sotalol.
ANd it is due to the POTS. If you see the first answer i clearly mentioned, avoid dehydration, take plenty of fluids minimum 2 litres a day.Thats the way to increase blood volume. Read the first answer again and you will see how the dots are connected.
Take care

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