Mirtazapine (remeron) - Help Me Understand How It Works!


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Kestonyyou Says:

Hello, I need help to understand how this antidepressant works 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 a blood pressure increase, and so it's hard for me 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. My medicine history story in a few sentences: After more than several heart tests a 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 sitting and talking to the cardiologist cuz of anxiety and many body posture changes, but it's in the 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 the 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 it's a serotonin and norepinephrine reuptaker? So how will it 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!

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