Effects of antidepressant treatment on heart rate variability in major depression: A quantitative review

Zyl, Louis T. van; Hasegawa, Takuya; Nagata, K.

doi:10.1186/1751-0759-2-12

Cited by 98 publications

(76 citation statements)

References 62 publications

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“…Some studies reported increased HRV during SSRI treatment (28,39,53), whereas others found no difference or a reduction (1,12,37). SNRIs were reported to reduce HRV in most of studies (41,54,56). In the present study, DVS increased the sympathovagal ratio (LF/HF) and sympathetic activity in the fed state.…”

Section: Discussionsupporting

confidence: 60%

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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: Discussionsupporting

confidence: 60%

“…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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“…216 They are associated with increased heart rate, orthostatic hypotension, slow cardiac conduction, increased risk of arrhythmias, and a 2-fold relative risk of myocardial infarction. 216 Although the potential adverse effect of antidepressants on HRV have been debated, 31,35,210,[217][218][219][220] these previously reported negative effects may be due to the inclusion of depressed participants who were already at an elevated risk for cardiovascular disease. 35 As the present meta-analysis excluded studies of individuals with known medical conditions that may influence HRV, the moderating effect of medication use in the case-control analysis is of particular interest and suggests that TCA use may exacerbate HRV reductions in patients with mood disorders.…”

Section: Effects Of Psychotropic Medication Use On Hrvmentioning

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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“…An effect size meta-analysis (19) revealed that depressed individuals treated with SSRIs showed a slight improvement in HRV when variability was assessed over a short 5-min timeframe (49). In contrast, studies (24,28) examining the effect of SSRIs when variability was assessed over 24 h showed contradictory results with evidence of an increase, decrease, or no change in HRV.…”

mentioning

confidence: 99%

Chronic fluoxetine reduces autonomic control of cardiac rhythms in rats with congestive heart failure

Henze

Tiniakov

Samarel

et al. 2013

American Journal of Physiology-Heart and Circulatory Physiology

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Henze M, Tiniakov R, Samarel A, Holmes E, Scrogin K. Chronic fluoxetine reduces autonomic control of cardiac rhythms in rats with congestive heart failure. Am J Physiol Heart Circ Physiol 304: H444 -H454, 2013. First published December 7, 2012 doi:10.1152/ajpheart.00763.2012.-Up to 40% of patients with heart failure develop depression, and depression is an independent risk factor for cardiovascular mortality in this patient population. Consequently, increasing numbers of patients with heart failure are treated with antidepressants. Selective serotonin reuptake inhibitors are typically the antidepressant of choice since this drug class has limited cardiovascular toxicity. However, little is known about the effects of selective serotonin reuptake inhibitors on autonomic cardiac regulation in congestive heart failure (CHF). Here, indexes of cardiac autonomic control were evaluated before and during chronic fluoxetine (FLX) treatment (20 mg·kg Ϫ1 ·day Ϫ1 , 5 wk) in rats that developed CHF after coronary artery ligation. FLX reduced the lowfrequency (LF) component of heart rate variability (HRV; P Ͻ 0.01) as well as the sympathetic contribution to LF HRV (P Ͻ 0.01) in both CHF and sham-operated rats. Both FLX and CHF reduced highfrequency HRV (P Ͻ 0.01). Spontaneous baroreflex gain was decreased in CHF rats 8 wk after ligation (P Ͻ 0.01). Cross-spectral coherence between the interbeat interval and mean arterial pressure was reduced in the LF domain 3 wk after ligation in CHF rats (P Ͻ 0.01) and was further reduced after chronic FLX treatment (P Ͻ 0.01). Plasma catecholamines and LF blood pressure variability were not affected by FLX. Chronotropic responses to both efferent vagal nerve stimulation and isoproterenol administration were reduced in CHF rats and by FLX (P Ͻ 0.01), whereas inotropic responses to isoproterenol were reduced only in CHF rats (P Ͻ 0.01). These data indicate that chronic FLX reduces the responsiveness to autonomic output controlling cardiac rhythm and may further compromise autonomic regulation of cardiac function in CHF.heart rate variability; selective serotonin reuptake inhibitor IT IS NOW WELL RECOGNIZED that patients who experience a myocardial infarction and subsequently develop congestive heart failure (CHF) have a high risk (up to 40%) of developing mood and anxiety disorders (13). Moreover, a diagnosis of depression is associated with increased morbidity and mortality in CHF patients. Individuals diagnosed with depression or anxiety disorders without underlying cardiovascular disease at the time of diagnosis also have a greater risk of dying of cardiovascular disease than do individuals without depression (54). As a consequence, increasing numbers of cardiovascular patients are being treated with antidepressant drugs. The most common antidepressant drugs used for the treatment of cardiovascular patients are the selective serotonin reuptake inhibitors (SSRIs) due to their relatively limited cardiovascular toxicity (43). However, little is known about how SSRIs influence cardiac autonom...

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Effects of antidepressant treatment on heart rate variability in major depression: A quantitative review

Abstract: Background: The literature measuring effects of antidepressant and electroconvulsive therapy (ECT) for major depression on heart rate variability (HRV) in medically well individuals was reviewed.

Cited by 98 publications

References 62 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

Chronic fluoxetine reduces autonomic control of cardiac rhythms in rats with congestive heart failure

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