Medication for Autonomic Disorders

Physicians typically prescribe medications to regulate blood pressure, which is often too low when people who have autonomic disorders are standing. These medications are used to increase blood pressure and prevent complications, such as dizziness, fainting, or falls. Most blood pressure medications are taken on a long-term basis.

Doctors often prescribe a mineralocorticoid medication called a fludrocortisone to increase water and salt retention and raise blood pressure in people with autonomic disorders. This medication is typically taken once daily by mouth. Side effects include high blood pressure, headaches, swelling of the ankles, low potassium levels, and kidney function problems.

Other medications our doctors prescribe to manage symptoms of orthostatic hypotension include the alpha agonist midodrine and the synthetic amino acid droxidopa. Both medications are short-acting pressor agents, which means they raise blood pressure for two to six hours after they are taken. Side effects include high blood pressure while lying down. 

Doctors advise people to take these medications only when they are upright and active—and to avoid lying down after they take them to avoid hypertension.

Your NYU Langone doctor monitors your blood pressure frequently to ensure that it remains in a healthy range while you take these medications. He or she can also offer practical tips to help prevent sudden changes in blood pressure.

Your doctor may prescribe medications for Parkinson’s disease if you have Parkinson’s-like symptoms. A combination of two medications—levodopa and carbidopa—can be used to reduce symptoms such as stiffness, balance problems, and slow movement in people with autonomic disorders. These medications are taken daily by mouth. Side effects include nausea and vomiting.

People who use levodopa for long-term treatment may find that the benefits decrease about three to five years after starting the medication. A person may also experience involuntary movements, called dyskinesia, after taking high doses. To control these effects, a doctor may lessen the dose or adjust the timing of doses.