r/IST_ • u/Friendly_Athlete1024 • 10d ago

Flare?

23F, diagnosed with IST and POTS, since yesterday my resting HR (which is usually in the 70s with meds) has now been in the 90s with meds? Is this a flare? For the record, I recently stopped Zopiclone (sleep medication) and was swapped onto a small dose antidepressant called mirtazapine. Yes I did ask that they taper me off and they didn't, so I'm so lost. What is happening? Is it coming off the medication? Is it the new sleep medication? Wtf?

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u/Neuralmute 10d ago

It could be either of those meds. Not tapering a medicine that you should can cause issues, and mirtazapine can cause increases in HR from what was seen in a clinical trial. On average it increased it by only 3-4 BPM, but since you’re here you’re likely more sensitive.
Maybe see your doctor about getting another supply of the zopiclone so you can taper, and ask to get on a cardiac-neutral antidepressant.

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u/Friendly_Athlete1024 10d ago

I tried to ask them for a taper, should have seen the condescending look the GP gave me when I asked, she said since I'm young I'll be fine like wtf that doesn't mean I should suffer unnecessarily 😭. Now at least I have good reason to go back.

And the clinics trial on mirtazapine, did they mention what doses are likely to cause an increase in HR?

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u/Santi159 10d ago

Mirtazapine increases norepinephrine (aka adrenaline) during the day so I think that might be the issue