Nonpharmacological Treatment of Postural Orthostatic Tachycardia Syndrome: Commentary and Implications for Psychologists

Objective: Postural orthostatic tachycardia syndrome (POTS) is a type of autonomic dysfunction that limits engagement in functional behaviors and negatively impacts mood and quality of life (QoL). Nonpharmacological strategies such as lifestyle modification are recommended as part of treatment; however, there is little research or theory regarding other nonpharmacological therapies used in treatment. Given the paucity of literature examining other nonpharmacological therapies for POTS, current evidence for their application to POTS was reviewed.Methods: A topical review was conducted to identify research studies that used nonpharmacological interventions to treat individuals with POTS.Results: Of the 370 identified studies, 25 met inclusion criteria. Sixteen of the 25 studies examined lifestyle modifications for POTS and were not described in the review, given that lifestyle modifications are already well accepted and recommended in nonpharmacological treatment of POTS. The remaining studies were grouped into three categories: Tactile Interventions, Mind-Body Interventions, and Interdisciplinary Treatment Programs. Findings suggest a variety of nonpharmacological interventions have the potential of benefiting patients with POTS; however, the scarcity of studies and methodological concerns limit the interpretability of this research.Conclusions: An agenda for future research and implications for psychologists are provided. With the help of psychologists to advance applied research in effective nonpharmacological strategies for treatment, patients with POTS will have access to additional treatment options that address their biopsychosocial needs and hopefully positively impact QoL.