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

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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there is the "paridoxal theory'', like adderal. which explains the NET.

Check out Wikipedia. It suggests that effexor is SNDRI. that means it will reuse existing dopamine within the synapse over and over again. I believe that when the brain gets tired it's response to stimulants will actually tire the brain like exercise does to your muscles.

As per anxiety; "Antagonism of the a2-adrenergic receptors" from Wikipedia.

My understanding is that it blocks adrenaline and reuses dopamine.

It reminds me of Hypervigilance; Wikipedia https:/­/­en.wikipedia.org/­wiki/­Hypervigilance

a very good description.

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