Antidepressive Treatment With Amitriptyline and Paroxetine: Comparable Effects On Heart Rate Variability

Lederbogen, Florian; Gernoth, C.; Weber, Bernhard; Colla, Michael; Kniest, Anja; Heuser, Isabella; Deuschle, Michael

doi:10.1097/00004714-200104000-00018

Cited by 34 publications

(19 citation statements)

References 12 publications

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“…A number of studies showed that antidepressant treatment impacted on HRV. Tricyclic antidepressants (TCAs) reduced parasympathetic tone and decreased HRV (22,24,56,58). Nortriptyline was reported to decrease sympathetic activity in patients under awake and sleeping conditions and decreased vagal activity in the awaking condition (58).…”

Section: Discussionmentioning

confidence: 99%

Inhibitory effects of desvenlafaxine on gastric slow waves, antral contractions, and gastric accommodation mediated via the sympathetic mechanism in dogs

Dai¹,

Lei²,

Chen

2011

American Journal of Physiology-Gastrointestinal and Liver Physi

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Desvenlafaxine succinate (DVS; Pristiq) is a new antidepressant, serotonin-norepinephrine reuptake inhibitor. Antidepressants have been widely used for the treatment of functional gastrointestinal disorders. Possible roles of DVS on gastrointestinal motility have not been studied. The aim of this study was to investigate the effects of DVS on gastric slow waves (GSW), antral contractions, and gastric accommodation in dogs. Fifteen healthy dogs implanted with gastric serosal electrodes and a gastric cannula were studied in four separate sessions: control, DVS (50 mg), propranolol (1 mg·kg Ϫ1 ·h Ϫ1 ), and propranolol ϩ DVS. GSW were measured via the gastric serosal electrodes. Antral contractions were assessed via an intraluminal manometric catheter inserted via the gastric cannula. The sympathovagal activity was assessed from the spectral analysis of the heart rate variability signal. Gastric tone was measured by barostat via an intragastric balloon inserted into the fundus via the gastric cannula. In the postprandial period, in comparison with the control, DVS reduced the percentage of normal GSW (P ϭ 0.001) and increased the percentage of tachygastria (P ϭ 0.005) and bradygastria (P ϭ 0.002). Simultaneously, DVS increased the sympathetic activity (P ϭ 0.006) and the sympathovagal ratio (low frequency/high frequency; P ϭ 0.044). These effects were blocked by propranolol. DVS attenuated postprandial antral contractions and gastric accommodation. The postprandial antral contractile index (area under the curve) was decreased by 26% with DVS (P ϭ 0.013), and gastric accommodation was decreased by about 50% with DVS (P Ͻ 0.001). The inhibitory effect of DVS on gastric accommodation was blocked by propranolol. DVS inhibits gastric contractions, slow waves, and accommodation in the fed state. These inhibitory effects are associated with an increased sympathetic modulation in the gastrointestinal system. Cautions should be made when DVS is used for treating patients with depression and gastric motility disorders. desvenlafaxine succinate; antidepressants; gastrointestinal motility ANTIDEPRESSANTS ARE WIDELY used for the treatment of functional gastrointestinal disorders, such as functional dyspepsia and irritable bowel syndrome (17,20,55). The rationale for the use of antidepressants in functional gastrointestinal disorders is based on the following potential effects. First, antidepressants may improve psychiatric and psychological symptoms, particularly anxiety and depression (11,18,47). Second, antidepressants have central analgesic actions and alter central processing of visceral pain stimuli (10, 27). Third, antidepressants may have local pharmacological actions on the gut and modulate gut sensorimotor functions (3,8,9).Desvenlafaxine succinate (DVS; Pristiq) is a new antidepressant, the third serotonin-norepinephrine reuptake inhibitor (SNRI) approved by the U.S. Food and Drug Administration for the treatment of major depressive disorders in 2008 (26, 35). It is a novel salt form of the isolated major active metab...

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Section: Discussionmentioning

confidence: 99%

Inhibitory effects of desvenlafaxine on gastric slow waves, antral contractions, and gastric accommodation mediated via the sympathetic mechanism in dogs

Dai¹,

Lei²,

Chen

2011

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…Duplicates were removed, titles and abstracts scanned, potential articles read and evaluated against inclusion criteria and authors contacted for additional data when necessary. In total, 140 case-control and 30 treatment 76,83,93,110,116,129,138,141,155,175,[187][188][189][190][191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206] studies were eligible for inclusion in the quantitative synthesis (151 case-control and 43 effect sizes for analysis); 10 of the studies were included in both the case-control and treatment analyses. 76,83,93,110,116,129,138,141,155,175 Four subgroups of disorders (mood, anxiety-related, psychotic and substance dependence disorders) and 2 classes of psychotropic medications (antidepressants and antipsychotics) were included.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Bär et al 189 Davidson et al 190 188 Dawood et al 110 Khaykin et al 191 Koschke et al 116 Lederbogen et al 192 Prasko et al 76 Rechlin 194 Rechlin 194 Rechlin et al 196 Tucker et al 83 Udupa et al 197 Udupa et al 198 Yeragani et al 201 189 Khaykin et al 191 Lederbogen et al 192 McLeod et al 193 Rechlin 194 Rechlin et al 195 Rechlin et al 195 Rechlin et al 196 Tulen et al 129 Udupa et al 198 Yeragani et al 199 Yeragani et al 200 …”

Section: Bär Et Almentioning

confidence: 99%

Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis

Alvares

Quintana

Hickie

et al. 2016

jpn

380

345

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“…Exclusion criteria for study subjects included: (1) failure to provide a history of medical illnesses (n ¼ 3), (2) not receiving regular treatment for medical illnesses (n ¼ 17), and (3) subjects with conditions which affect cardiovascular fluctuations: an implanted cardiac pacemaker, frequent occurrence of atrial fibrillation, premature atrial or ventricular contractions, or other forms of arrhythmia (n ¼ 35). Because of the anticholinergic properties of antidepressants, it has been shown that not only treatment with tricyclic antidepressants but also selective serotonin reuptake inhibitors decreases HRV (Rechlin et al, 1994;Lederbogen et al, 2001). Due to the limited number of subjects (n ¼ 2) who took antidepressants during the study period, we excluded these two subjects as well for the sake of inadequate power as a covariate.…”

Section: Participantsmentioning

confidence: 99%

Gender differences in the relationship between depression and cardiac autonomic function among community elderly

Chen

Yang

Kuo

et al. 2009

Int J Geriat Psychiatry

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Antidepressive Treatment With Amitriptyline and Paroxetine: Comparable Effects On Heart Rate Variability

Cited by 34 publications

References 12 publications

Inhibitory effects of desvenlafaxine on gastric slow waves, antral contractions, and gastric accommodation mediated via the sympathetic mechanism in dogs

Inhibitory effects of desvenlafaxine on gastric slow waves, antral contractions, and gastric accommodation mediated via the sympathetic mechanism in dogs

Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis

Gender differences in the relationship between depression and cardiac autonomic function among community elderly

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