hi there I have been on velafaxine for 4 years now, last year I had a relapse of my depression and my dose has since been uped t 225 mg and I am also now on mirtazipine 30 mg at night, I mentioned to my psychiatrist last year of muscle twitches they are still present now and they get quite bad at time i have accidently hurt myself, they seem unconcerned about the twitches but over the past few months i have had frequent pins and needles in my back that is like a burning sensation and my heart rate at times goes up to 120 beats a minute and my pupils are scarily dilated. should i be concerned about this?, I am afraid to bring it up to my psychiatrist as I feel they think it is all in my head.