Diagnosed with P.O.T.S. in 2001, but not treated until 2009. Instructed to check blood pressure and heart rate morning, noon and evening. Based on the readings, I take Midodrine for the low blood pressure, and Bisoprolol for tachycardia. The amounts that I take of these meds is dependent on my current BP & HR. It's working so far - prior to this treatment plan, I was having a lot of problems. The Midodrine was started first, but I asked to try a beta blocker because of the chronic tachycardia (which the Midodrine didn't have any effect on). The combination of the two meds is what did the trick for me, and the freedom to adjust the dose of both on my own has made all the difference in the world.

I have Vaso Vagal Syncope, it's very similar to P.O.T.S. I also take Midodrine. I take Metoprolol for the tachycardia and when my BP is too high. I am really struggling to keep my BP and HR leveled out. My doc told me the same thing you are doing. I'm just really frustrated with this. The meds help sometimes, and other times they don't help enough.