Beyond the Session: In-Depth Answers to Your Mental Health Questions

Q: Moonradiate asks: “How do you manage lithium in a person with POTS?”

A: Postural orthostatic tachycardia syndrome (POTS) is a disorder of the autonomic nervous system that causes an abnormally large increase in heart rate when sitting up or standing. POTS can cause dizziness, lightheadedness, and a rapid heartbeat, which are relieved by lying down again. If the person with POTS is standing up while these symptoms are occurring and not able to lie down, they may even pass out as the body wants to maintain homeostasis (balance) and not go into autonomic instability with too high of a heart rate and lowering of blood pressure which can lead to shock.

Managing lithium in a person with POTS involves similar aspects as those without POTS with a few specific considerations due to the unique challenges posed by POTS symptoms, primarily related to blood pressure and heart rate regulation. Here are the key points to consider: