Autonomy of Autonomic Dysfunction in Major Depression

Koschke, Mandy; Boettger, Michael Karl; Schulz, Steffen; Berger, Sandy; Terhaar, Janneke; Voss, Andreas; Yeragani, Vikram K.; Bär, Karl‐Jürgen

doi:10.1097/psy.0b013e3181b8bb7a

Cited by 181 publications

(129 citation statements)

References 54 publications

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“…Remarkably, starting selective serotonin re-uptake inhibitor (SSRI) use was found to cause a decrease in HR in spite of lowered vagal activity (Licht et al, 2010), which suggests that SSRI use leads to a decrease in cardiac sympathetic control. Similar results were found by other research groups: Roth et al (1988) and Koschke et al (2009) reported increases in HR after administration of imipramine (a TCA) and venlafaxine and duloxetine (SNRIs). Shores et al (2001) and Barton et al (2007) found decreases in plasma NE, after SSRI use.…”

Section: Introductionsupporting

confidence: 79%

“…mental health-care practice, reflects the general population of depressed and anxiety patients. Several reports using different SNS indices also found increased sympathetic activity in depressed or anxious subjects (Esler et al, 1982;Gold et al, 2005;Guinjoan et al, 1995;Light et al, 1998;Koschke et al, 2009). These previous reports focused on general sympathetic activity, whereas we measured sympathetic control more narrowly by its effects on cardiac contractility.…”

Section: Discussionmentioning

confidence: 80%

“…Various studies reported increased sympathetic activity in depressed and anxious subjects compared with healthy controls, measured by different indices like spillover of norepinephrine (NE) and epinephrine (EPI), skin conductance responses, QT interval variability (QTvi), or the pre-ejection period (PEP) (Light et al, 1998;Esler et al, 1982;Guinjoan et al, 1995;Gold et al, 2005;Koschke et al, 2009;Barton et al, 2007). However, other studies reported no association between psychopathology and SNS activity or reported decreased SNS activity in subjects with depressive or anxiety disorders (Wilkinson et al, 1998;Esler et al, 2004;Roth et al, 2008;Ahrens et al, 2008), so findings remain inconclusive.…”

Section: Introductionmentioning

confidence: 83%

“…Shores et al (2001) and Barton et al (2007) found decreases in plasma NE, after SSRI use. These patterns of findings suggest differential effects of different antidepressants (Dawood et al, 2009;Licht et al, 2009a;Koschke et al, 2009).…”

Section: Introductionmentioning

confidence: 83%

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Effects of Antidepressants, but not Psychopathology, on Cardiac Sympathetic Control: A Longitudinal Study

Licht

Penninx

Geus³

2012

Neuropsychopharmacol

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Increased sympathetic activity has been hypothesized to have a role in the elevated somatic disease risk in persons with depressive or anxiety disorders. However, it remains unclear whether increased sympathetic activity reflects a direct effect of anxiety or depression or an indirect effect of antidepressant medication. The aim of this study was to test longitudinally whether cardiac sympathetic control, measured by pre-ejection period (PEP), was increased by depression/anxiety status and by antidepressant use. Cross-sectional and longitudinal data were from a depression and anxiety cohort: the Netherlands Study of Depression and Anxiety (NESDA). Baseline data of 2838 NESDA subjects (mean age 41.7 years, 66.7% female) and 2-year follow-up data of 2226 subjects were available for analyses. Included were subjects with and without depressive/anxiety disorders, using or not using different antidepressants at baseline or followup. The PEP was measured non-invasively by 1.5 h of ambulatory impedance cardiography. Cross-sectional analyses compared PEP across psychopathology and antidepressant groups. Longitudinal analyses compared 2-year changes in PEP in relation to changes in psychopathology and antidepressant use. Cross-sectional analyses showed that antidepressant-naïve depressive/anxious subjects had comparable PEP as controls, whereas subjects using tricyclic (TCA) or combined serotonergic/noradrenergic antidepressants (SNRI) had significantly shorter PEP compared with controls. In contrast, subjects using selective serotonin re-uptake inhibitors (SSRIs) had longer PEP than controls. Longitudinal results confirmed these findings: compared with 2-year change in PEP in continuous non-users ( + 2 ms), subjects who started TCA or SNRI treatment showed significantly shortened PEP (À11 ms, p ¼ 0.005 and po0.001), whereas subjects who started SSRI treatment showed significant prolongation of PEP ( + 9 ms, p ¼ 0.002). Reversed findings were observed among those who stopped antidepressant use. These findings suggest that depressive and anxiety disorders are not associated with increased cardiac sympathetic control. However, results pose that TCA and SNRI use increases sympathetic control, whereas SSRI use decreases sympathetic control.

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Section: Introductionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 83%

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Effects of Antidepressants, but not Psychopathology, on Cardiac Sympathetic Control: A Longitudinal Study

Licht

Penninx

Geus³

2012

Neuropsychopharmacol

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“… no pathological cardiovascular conditions, neurological or psychiatric disorders [19,20] or other severe diseases;  not taking any medication at the time of the study;  not professional athletes or high-level sport participants;  not caffeine or alcohol in the 12 hours prior to the measurements.…”

Section: Methodsmentioning

confidence: 99%

Blood Pressure Drop Prediction by using HRV Measurements in Orthostatic Hypotension

et al. 2015

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A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. Abstract This paper presents a model to predict the systolic blood pressure drop due to postural hypotension, relying on heart rate variability measurements extracted from 5 minute ECGs recorded before standing. This model was developed and tested with the leave-one-out cross-validation technique enrolling 10 healthy subjects and finally validated with additional 5 healthy subjects, whose data were not used during the training and testing cross-validation process. The results show that the model predicts correctly the systolic blood pressure drop in 80% of whole experiments, with an error below the measurement error of a sphygmomanometer digital device.G. Sannino Institue of High Performance Computing and Networking (ICAR -CNR) via pietro castellino,

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Gastrointentinal Manifestations of Systemic Diseases

Israeli

Bernstein

2015

Yamada' S Textbook of Gastroenterology

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Autonomy of Autonomic Dysfunction in Major Depression

Abstract: Patients suffering from MDD show profound autonomic dysfunction, which is exacerbated by SNRI and to a lesser degree by SSRI treatment. This information could prove important when selecting antidepressant medication for patients at risk for cardiac arrhythmias.

Cited by 181 publications

References 54 publications

Effects of Antidepressants, but not Psychopathology, on Cardiac Sympathetic Control: A Longitudinal Study

Effects of Antidepressants, but not Psychopathology, on Cardiac Sympathetic Control: A Longitudinal Study

Blood Pressure Drop Prediction by using HRV Measurements in Orthostatic Hypotension

Gastrointentinal Manifestations of Systemic Diseases

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