Kestonyyou: Mirtazapine (Remeron) how does it work and how it affect cardiovascular system?

[Kestonyyou]

Hello, I need help to understand how this antidepressant work for anxiety. I am suffering from severe anxiety (suspected hyperadrenergic postural orthostatic tachycardia syndrome - hyper pots) which causes my heart rate to increase by 30-50 beats per minute upon standing along with blood pressure increase, and so it's hard for even to even stand because of heart palpitations, fatigue, dizziness etc, and so i lay in my bed for 22-23 hours daily for 8 months, my muscles are GONE, i am only existing. Medicine history story in few sentences: after more than several heart tests year ago, they found nothing except mentioned sinus tachycardia episodes and high blood pressure when anxious, for example it was 170/90 with the heart rate of 120 just sittting and talking to cardiologist cuz of anxiety and body many posture changes, but it's in 40s when i sleep and it varies from 50s to 140s every hour during the day, which cardiologists think relates to anxiety. I decided to go to psychiatrist and so she saw severe anxiety and gave me ssri antidepressant escitalopram which made me a lot worse, my heart rate was 90-100 even when i wanted to go to sleep. Now she wants to put me on mirtazapine and i just can't understand how it can work because its serotonin and norepinephrine reuptaker, so how it will reduce my anxiety if i will have more norepinephrine in my blood, i thought they will block it, not increase it. This is a paradox that i fail to understand, what kind of treatment is that? I am scared that this will increase my anxiety/panic attacks/heart rate/blood pressure just like escitalopram. What were your experiences with it? Thank you!

[mammaP]

Hi Kestonyyou, welcome to SA. You are right to be wary of another remeron , it is not likely to be any help at all changing drugs. When doctors don't know what to do they prescribe psychotropic drugs instead of looking at the whole person. I am sorry to see that you are suffering so much. 

When did your anxiety problem start?  

 

When did you start escitalopram? If it is causing side effects it might be better to taper off it.

http://survivingantidepressants.org/index.php?/topic/406-tapering-off-lexapro-escitalopram/

 

You can learn to manage anxiety, it is a physical response and caused by exess cortisol. Very distressing and I sympsthise with you.

You can learn some non drug techniques here. 

 

http://survivingantidepressants.org/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

Do you take anything else at alll, any other drugs or supplements? 

Have you taken any other drugs in the past?

 

It will help us if you can fill in your signature, this link will take you to the signature box in settings. We need drugs, doses, and when started and stopped.

http://survivingantidepressants.org/settings/signature/

 

Edited August 9, 2017 by mammaP

[mammaP]

This topic might help you. It talks about symptoms like yours that can be helped by very gentle exercise.