I have a complicated patient who has multiple medical problems. She is a 39-year-old female with neurocardiogenic syncope (Abnormal tilt table study), sarcoidosis, including the myocardium by cardiac MRI, symptomatic PVCs that were improved with Prednisone, mitral valve prolapse with mild MR and migraine. She had unsuccessful ablation for PVCs. She has been treated with Midodrine 10 mg po tid and Metoprolol succ 25 mg, 1 1/2 tablet po bid She weas compression stockings. She had a normal nuclear stress test. She has been on multiple medications including the above , in addition Plaquenil, Pepcid, Methotrexate. Mg oxide, Carafate. She recently presented with presyncopal episode while standing at work. Her office BP was 119/69 with no orthostatis in one minute. Is it the time to change Midodrine to Northera in this complicated patient? Thanks.