Should I discontinue Mirtazapine due to a rapid heartbeat?
Two weeks ago, my physician prescribed me 15mg of Mirtazapine, which has significantly improved my insomnia. However, I’ve observed a concerning increase in my heart rate, which has risen approximately 20 beats per minute. My current resting heart rate fluctuates between 88 and 95 bpm, whereas it used to be considerably lower. I’m questioning if I should cease the use of this medication. Might the beta blocker I’m on have become ineffective? I have a condition known as inappropriate sinus tachycardia, which I manage effectively with bisoprolol at a dose of 2.5mg. Is this heart rate elevation a typical reaction to Mirtazapine? I’m a 33-year-old female.
Answers (1)
12/13/2025, 7:10:43 PM
OpenHealth AI
It's understandable to be concerned about a rapid heartbeat, especially after starting a new medication like Mirtazapine. While increased heart rate can occur with this medication, it’s important to assess your specific situation and take careful steps.
Explanation:
Mirtazapine is an antidepressant that can impact various bodily functions, including heart rate. Some individuals may experience an elevation in heart rate, particularly if they have underlying conditions such as inappropriate sinus tachycardia. It’s also worth noting that medications like beta blockers, including bisoprolol, can sometimes lose effectiveness over time or may react in unexpected ways when paired with other medications.
Given your report of an increased resting heart rate and considering your existing condition, it's very important to approach this situation thoughtfully.
Next Steps:
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Monitor Your Heart Rate: Keep a daily log of your heart rate at rest, noting any correlations with dosages of Mirtazapine and bisoprolol. This will help you identify any patterns or correlations.
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Assess Symptoms: Pay attention to any additional symptoms you may experience, such as dizziness, shortness of breath, or chest pain, and note these in your log as well.
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Contact Your Physician: Before making any changes to your medication, reach out to your healthcare provider. Share your observations about the increased heart rate and discuss your concerns. They may consider adjusting your beta blocker dose, switching medications, or exploring further evaluation of your heart rate.
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Avoid Stimulants: In the meantime, reduce or eliminate caffeine and other stimulants to see if it helps lower your heart rate.
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Relaxation Techniques: Consider incorporating relaxation strategies such as deep breathing exercises or mindfulness practices to help manage your heart rate and anxiety.
It's essential to prioritize communication with your physician regarding any medication adjustments. Taking these steps can help you navigate your concerns while ensuring safe and effective management of your insomnia and heart health.
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