Can mirtazapine cause heart palpitations? (3+ tips )

In this blog post, we are going to answer the question, “Can mirtazapine cause heart palpitations?”. Mirtazapine is an antidepressant which is used to treat a variety of mental health related problems. 

However, this medicine can cause a number of side effects including heart palpitations. This blog will cover why mirtazapine causes this side effect and what could be done to help get rid of it. 

Can mirtazapine cause heart palpitations? 

Yes, mirtazapine can cause heart palpitations in some individuals. Several research studies have indicated that mirtazapine can cause QT prolongation, a condition in which your heart beats faster and harder. 

This is the main cause of palpitations felt by some of the people while being on mirtazapine. 

However, it may not affect everyone in the same way. Some people are born sensitive to medications and they develop all sorts of side effects that a normal person may not develop. 

If you suffer from heart palpitations right after taking the first ever dose of mirtazapine, it can indicate the occurrence of an allergic reaction. Make sure you immediately reach out to your healthcare provider if you exhibit any sign of an allergic reaction or any unusual side effect while being on mirtazapine. 

How do heart palpitations affect you? 

Heart palpitations are abnormal heartbeats, which are too hard and fast. You can literally feel your entire heart beating in your chest. You may notice heart palpitations in your chest, neck or shoulders.

They can be scary or bothersome. Palpitations are not that harmful and can fade away on their own, but they are considered dangerous when coupled with following symptoms:

• Shortness of breath
• Dizziness
• Chest pain
• Fainting

Is there anything you can do to get rid of mirtazapine induced heart palpitations? 

Following are a few tips that might help relieve palpitations:

Try relaxing techniques

Relaxing techniques can surely calm a racing heart. You can try:

• Deep inhaling and exhaling
• Yoga
• Meditation
• If you’re working, try to take a break.
• Sit down comfortably and have a cup of your favourite tea. 

Avoid taking stimulants

If you’re experiencing heart palpitations, the worst thing to do is consuming things which can stimulate cardiac muscle contraction even more. These include:

• Illicit drugs
• Smoking
• Drinking too much alcohol
• Drinking too much caffeine and carbonated beverages
• Appetite suppressants

Make sure your electrolytes are balanced

Electrolytes like sodium, potassium, calcium etc play an important role in cardiac muscle contraction. Make sure your electrolytes are within normal range, not too low or not too high.

Stay hydrated

Make sure you drink plenty of water. Dehydration can disturb your blood volume which can trigger heart palpitations. 

Exercise regularly

Make sure you make exercise an important part of your routine. Cardio workouts can strengthen your heart muscles and make them able to withstand stress and pressure. This not only keeps your heart healthy, but can also prevent heart diseases. 

What other medications can cause heart palpitations? 

Some medications can cause heart palpitations, these include:

• Anti-asthmatic medicines, which include salbutamol and ipratropium bromide
• Antihypertensive agents 
• Antihistamines, also called anti-allergies.
• Antimicrobial therapy with macrolides, which include drugs like erythromycin, clarithromycin etc. Azithromycin of this class is the most common antibiotic for triggering heart palpitations in women. 
• Antifungal medicines, which include ketoconazole, itraconazole etc.

Always contact your healthcare professional before starting the use of any medication. Drug interactions should be an important consideration before taking two or more medicines together. Yes, drugs in combination are often used to achieve better therapeutic response but this is not the case with every interaction. 

Some drugs are highly incompatible with one another. They often cancel out each other’s effects or antagonise them. Some drugs are so incompatible that they end up changing the entire chemical composition of one another. 

Some interfere with metabolism or bioavailability (the rate and extent at which the active drug moiety enters systemic circulation/blood). This can lead to drug accumulation in different parts of the body. 

It is always advised to inform your healthcare provider of any medicine you take before getting a new prescription. Your doctor will make sure not to prescribe any such drug which might interfere with those you are already taking. 

What are the other causes of heart palpitations? 

Other health related causes of heart palpitations include:

• lifestyle factors
• emotions and psychological triggers
• hormone changes
• heart rhythm problems
• heart conditions
• other medical conditions

Lifestyle factors

Lifestyle factors are considered most important in regulating your heart rate and blood pressure. Palpitations can be triggered by high intensity exercises, excessive use of alcohol and caffeine, poor sleep quality, overeating or eating too much spicy food.

Palpitations triggered by such factors are not so dangerous and can go away on their own. However, you need to maintain a healthy lifestyle if you don’t want them to come back.

Emotional or psychological factors

Heart palpitations are also often caused by emotions or psychological issues, such as excitement or nervousness, stress or anxiety and panic attacks (sudden, uncontrollable attacks of fear and worry. A patient might unwillingly exaggerate a certain condition and gets frightened)

Hormonal changes

Heart palpitations in women can sometimes be the result of hormonal changes that happen during periods, pregnancy, or menopause. In these cases, the palpitations are usually temporary and are not something to be concerned about. 

Problems associated with heart rhythms

Palpitations can also be triggered by some heart conditions associated with arrhythmia. These conditions include:

• A condition called atrial fibrillation, in which heartbeats are fast and irregular.
• A condition known as supraventricular tachycardia (SVT), which is characterised by unusual fast heartbeats.
• A condition called ventricular tachycardia, which is a dangerous condition. It involves irregular heartbeat and can sometimes cause unconsciousness 

Other medical conditions

Other medical conditions that can cause heart palpitations include:

• Hyperthyroidism, a condition in which there is overproduction of thyroid hormones by thyroid gland, as a result of its over activity
• Hypoglycaemia, which in simple words mean low blood glucose level.
• Anaemia, which indicates the deficiency of red blood cells. In this condition, the heart works faster to provide enough oxygen to all cells of the body. 
• Orthostatic hypotension, a condition which causes dizziness triggered by standing up too fast.
• Fever
• Dehydration 

What are the additional side effects of mirtazapine? 

The common side effects of mirtazapine include:

• Sleepiness or drowsiness 
• Excessive tiredness or fatigue 
• Dizziness or lightheadedness 
• Xerostomia or dry mouth 
• Anxiety 
• Agitation 
• Confusion 
• Gain of appetite
• Weight gain 
• Gastrointestinal side effects including nausea, vomiting and diarrhoea/Constipation 

Mirtazapine is also associated with some serious side effects, which may include:

• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
• Convulsions 
• QT prolongation 
• Pain and tightness in chest
• Arrhythmia 
• Flu like symptoms 

These side effects can vary from person to person. People who are on higher doses are more susceptible to these side effects. Report any problems with bleeding or bruising to your doctor. 

If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your healthcare provider. 

Mirtazapine come with a suicidal warning in people younger than 24 years of age. If you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can. 

Do not stop this med abruptly. If it’s time for you to stop mirtazapine, your doctor will simply make a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

When to call your doctor

You don’t necessarily have to call your doctor if you experience palpitations, especially after your doctor has increased the dose of your mirtazapine. 

Seeking medical care depends on the intensity of your palpitations. If they are strong and disabling, immediately contact your healthcare provider. If they are mild, don’t worry! It’s just your body trying to adapt to the new dose of mirtazapine.

Conclusion 

In this blog post, we have talked about mirtazapine induced heart palpitations. Mirtazapine is an atypical antidepressant which is used for a number of conditions. However, this medicine can cause a number of side effects including heart palpitations. 

Several research studies have indicated that mirtazapine can cause QT prolongation, a condition in which your heart beats faster and harder. This is the main cause of palpitations felt by some of the people while being on mirtazapine.

If you feel this way after taking your first ever mirtazapine dose, it could mean that the med doesn’t suit you or you’re too sensitive for the dose you are starting it with. Make sure you use this antidepressant or any other medication only when your doctor has advised it.

FAQs: mirtazapine heart palpitations

Are heart palpitations a side effect of antidepressants?

Yes, antidepressants can cause heart palpitations. Several research studies have indicated that antidepressants can cause QT prolongation, a condition in which your heart beats faster and harder. This is the main cause of palpitations felt by some of the people while being on antidepressants. However, heart palpitations can also be experienced after an increase or decrease in dose, or when you start on a dose which is too high for you. It is also experienced while tapering off an antidepressant. 

Do all antidepressants cause heart palpitations?

No, not all antidepressants cause heart palpitations. In fact, antidepressants which are commonly known for causing heart palpitations may not cause this side effect in every other individual. However, some antidepressants are considered safer for cardiac patients. Fluvoxamine, fluoxetine and paroxetine, other members of the SSRI family, are considered safer for the cardiovascular system. They can be used to cure depression and anxiety in people living with cardiovascular diseases. 

How long does it take for the side effects of mirtazapine to go away?

Mirtazapine induced side effects usually begin to subside within a few weeks of your treatment. However, this time duration can vary from person to person. Some people start to recover way earlier than the others. Make sure you inform your healthcare provider if you exhibit any sign of an allergic reaction or any other unusual side effect while being on mirtazapine. 

What are the serious side effects of mirtazapine?

Mirtazapine is associated with some serious side effects, which may include:

• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
• Convulsions 
• QT prolongation 
• Pain and tightness in chest
• Arrhythmia 
• Flu like symptoms 

When should I be worried about heart palpitations?

Immediately reach out to your healthcare provider if you experience shortness of breath, dizziness, chest pain and fainting

What does a heart palpitation feel like?

Heart palpitations are abnormal heartbeats, which are too hard and fast. You can literally feel your entire heart beating in your chest. You may notice heart palpitations in your chest, neck or shoulders.

They can be scary or bothersome. Palpitations are not that harmful and can fade away on their own, but they are considered dangerous when coupled with following symptoms:

• Shortness of breath
• Dizziness
• Chest pain
• Fainting

References 

• Paige Fowler – Which Medicines Might Raise My Heart Rate? https://www.webmd.com/heart-disease/atrial-fibrillation/medicines-raise-heart-rate
• Rick Ansorge – Heart Palpitations https://www.webmd.com/heart-disease/guide/what-causes-heart-palpitations
• Heart palpitations and ectopic beats https://www.nhs.uk/conditions/heart-palpitations/#:~:text=Heart%20palpitations%20are%20heartbeats%20that,in%20your%20throat%20or%20neck.
• S A Anttila et al. CNS Drug Rev. Fall (2001) – A review of the pharmacological and clinical profile of mirtazapine https://pubmed.ncbi.nlm.nih.gov/11607047/
• Mirtazapine Tablet – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-13706-4047/mirtazapine-oral/mirtazapine-oral/details#:~:text=Mirtazapine%20is%20used%20to%20treat,(neurotransmitters)%20in%20the%20brain.
• National Library of Medicine – Mirtazapine https://medlineplus.gov/druginfo/meds/a697009.html