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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!
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aga02916 kestonyyou
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kestonyyou aga02916
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Thank you for responding, I appreciate that. What I fail to understand is that this medication mirtazapine prevents noradrenaline and serotonin from becoming bound to the nerve cells. This enhances the mood-lightening effect of free noradrenaline and serotonin that is released from nerve cells, and helps relieve depression - which means I will have more noradrenaline in my blood - which will result in more anxiety, higher heart rate etc etc. I just don't understand how it may help my anxiety by increasing the actions of norepinephrine.
aga02916 kestonyyou
Posted
aga02916
Posted
kestonyyou aga02916
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I fear too much, cuz it doesn't make any sense. It enhances noradrenaline, and wiki says: The general function of norepinephrine is to mobilize the brain and body for action. Norepinephrine release is lowest during sleep, rises during wakefulness, and reaches much higher levels during situations of stress or danger, in the so-called fight-or-flight response. So, without swearing, i cannot describe this.. How can u heal my anxiety and too much norepinephrine feeling by enhancing it. Thanks for responding mate, i appreciate it a lot
aga02916 kestonyyou
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james87669 kestonyyou
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I think you will find that most people on this site taking mirtazapine including myself say that it is not very good at managing anxiety. Great for sleep and that's about it.
GotPots kestonyyou
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Do not take SNRIs with hyperadrenegic pot. SNRIs such as Wellbutrin and Remeron increase norepinephrine levels which is already increased in hyperadrenegic pots patients. This will make your POTS worse increasing heart rate. It also can lower your blood pressure from the extreme drowsiness it causes.
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