thanks. What's frustrating is that there appears to be differences in the information that doctors use. I'll try to research if there are any anti-dp's that don't affect the heart.

You can start here:
http://www.medsafe.govt.nz/profs/adv...s151.htm#3.2.1

Put mirtazapine into your "find" tool in your browser and you
will get this:
According to the above site (from New Zealand), more data and research are needed for accurate therapeutic use in patients with heart beat problems.

Keep in mind the "old boys" on committees are making the decisions about drugs. They do this too with therapeutic textbooks. And an example of this is the failure for those "old boys" to update the B12 therapeutic manuals also.

I continually post the 2003 American Association of Family Physicians site which does try to educate American practicing doctors about new B12 information...but we still see here doctors who are not testing patients with neurological problems to see if low B12 is the reason.

So I do think people should search and find some information themselves.

People with heart beat irregularities should maintain good potassium and magnesium levels....when these get low from poor diet, or dehydration from illness the risk of arrhythmias increases for those who have already a diagnosed one.

Also combining drugs that have similar risks, increases the risk to the patient much more than just taking one such drug.

RBBB is sometimes associated with long QT... as it is a slowing of the conductivity of part of the heart. Since you do not see a cardiologist, you cannot know your real risks with this disorder, as people vary.

jshire,

I am glad you have asked the question!
This is VERY important issue and information!

I am in the U.S. and find some psychopharmacologists minimize the potential effects upon the heart, even when a person has a clear heart issue.

In the past, I have had (very wise) pharmacists refuse to fill the doctors orders because the doctor was not careful enough and was combining two meds which had this heart QT potential.

It's critical people take an interest, do research, ask lots of questions.
People feel less like following through on all of this when depressed/low energy, etc.

Thankfully, your question here has been met with very sound, scientific information and advice.

I know you'd written many do not see a cardiologist in the UK re: your cardiac issue for med consults. I'd personally push for a consult anyway, if at all possible.

I know psychopharmacologists here in the U.S. favoring the use of mirtazapine with cardiac patients.

In any case, due diligence and caution are in order.
Great question.

I hope you obtain further clarity on the best options soon.

To our Health,
DejaVu

thanks. yes, here in the UK RBBB is classed as common & does not mean you can get to see a cardiologist unless it is causing problems.

frustrated !

so, I had an appointment with my doctor & I told him I hadn't started taking the mirtazapine because of finding out that one if its main side effects is putting on weight & I thought that actually that would increase my depression + at my age add to the risk of diabetes + that it has been linked to side effects that are similar to PN & so thought it best not to risk that before seeing a neurologist to assess my possible PN. His response was to clearly be frustrated with me for checking things online. He said 'online groups that focus on one condition can be a good thing but perhaps they should try sorting you out if they're giving you advice like this'. Now, I can understand that doctors probably do get fed up of people coming in with info they've found online but as he didn't even mention PN until I suggested it could be a possibility I think he's not exactly being helpful. I simply need to find an anti-dp that I can take considering I have RBBB & that doesn't have a main side effect of putting on lots of weight. He seemed to imply there aren't any others I can try. Here in the UK swapping doctors can be complicated but a part of me feels like I can't keep going back to my current gp with the same questions.

If you have SAMe where you are, you could try this.

It is a natural compound that your body makes under ideal nutritional conditions.

Since SAMe came from Europe to US, you must have it there?

To enhance your own manufacture of this methylating compound, B6, folate, B12 and omega-3's have to be present. If you have the DNA mutation called MTHFR...you cannot methylate your vitamins in food to the active forms that are used to make SAMe.

http://www.lifeextension.com/Magazin...t_same/Page-01

I've used 400-600mg a day orally for a decade now.

If you start it, do 200mg a day in the morning for at least 2 weeks and raise it slowly. Some people only need 200mg a day and others do better with 400mg or 600mg a day. It is quite energizing, so only take it in the morning on an empty stomach.

thanks - you can get SAM-e tablets here in the UK, though they're expensive. Lots of stuff online about the side-effects of that also of course, but i'll keep researching it.