Orthostasis (lightheadedness or fatigue on standing) can be due to medications, dehydration, diabetes mellitus, other causes. Medications such as tricyclics, muscle relaxants, antipsychotics, Parkinson's medications, alpha-blockers, and diuretics are examples. Arise slowly, limit alcohol and heat exposure, elevate the head of the bed. Consider drinking two glasses of water before a triggering event such as rising or taking a medication. Fludricortisone may help by increasing sodium and water retention. A vasoconstrictor such as midodrine may help, as well. Postprandial hypotension may be a consideration - eat small, low-carbohydrate meals. Caffeine or acarbose may lessen post-meal blood pressure drops.

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References and Notes
Lancet	Wiersinga J, Jansen S, Peters MJL, et al. Hypertension and orthostatic hypotension in the elderly: a challenging balance. Lancet Reg Health Eur. 2024 Dec 3;48:101154.
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