Heart Rate Variability During Antidepressant Treatment With Venlafaxine and Mirtazapine

Terhardt, Johannes; Lederbogen, Florian; Feuerhack, Anne; Hamann-Weber, Bettina; Gilles, Maria; Schilling, Cláudia; Lecei, Olivera; Deuschle, Michael

doi:10.1097/wnf.0b013e3182a76fbb

Cited by 33 publications

(18 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Atypical antidepressants (e.g. mirtazapine, trazodone) were also excluded because very few studies exist on their effect on HRV and results are conflicting [57], [151], [157]–[159]. We instead allowed medications whose influence on HRV has consistently been found to be nil to limited – selective serotonin reuptake inhibitors (SSRIs) [56], [57], [151], [152] and diuretics [160], [161] - or remains controversial despite a rather large body of research- peripherally-acting CCBs [148], [149], [161]–[164] and benzodiazepines [154], .…”

Section: Discussionmentioning

confidence: 99%

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

et al. 2014

View full text Add to dashboard Cite

BackgroundMild cognitive impairment (MCI) is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.AimTo conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA) of heart rate variability (HRV) at rest and during provocative manoeuvres.MethodsThis cross-sectional study involved 80 older outpatients (aged ≥65) consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls) based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions—supine rest with free breathing (baseline), supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation), and active standing (orthosympathetic stimulation)—with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn) and high frequency (HFn) powers and the LF/HF ratio. Blood pressure (BP) was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.ResultsThere were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.ConclusionsOur study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will determine its prognostic relevance as a predictor of adverse health outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…However, recent research in an adult cohort indicated that the relationship between depression and CAC may be driven by the use of antidepressants rather than by the depression itself: antidepressantnaïve depressed patients did not display altered CAC compared with controls, whereas users of different antidepressants had higher HR, lower HRV, and shorter PEP compared with healthy controls (17)(18)(19). Several studies support the HRV-lowering effects of antidepressants, although findings are not always consistent in magnitude and direction for all types of antidepressants (14,20,21).…”

Section: Introductionmentioning

confidence: 99%

The Association Between Depressive Disorder and Cardiac Autonomic Control in Adults 60 Years and Older

Licht

Naarding

Penninx

et al. 2015

Psychosomatic Medicine

View full text Add to dashboard Cite

show abstract

“…Our study did not find a significant effect from venlafaxine and mirtazapine on the autonomic system. However, some studies have pointed out an association between venlafaxine, mirtazapine and HRV [31]. Mirtazapine has been suggested to cause a decline of parasympathetic modulation, which may result from its anticholinergic properties [19].…”

mentioning

confidence: 99%

The Effects of Antidepressants and Quetiapine on Heart Rate Variability

et al. 2016

View full text Add to dashboard Cite

The autonomic effects of antidepressants and quetiapine on heart rate variability (HRV) are inconsistent based on past studies. The aim of this study was to explore their influence on the HRV of psychiatric patients without psychotic symptoms. A total of 94 patients with depression, anxiety, or somatic symptoms, were recruited into this study. Based on their medication, 4 groups were identified: the no antidepressant group (n=19), the SSRI group (using sertraline or escitalopram, n=53), the other antidepressants group (using venlafaxine or mirtazapine, n=9), and the augmentation group (AG, using an antidepressant+quetiapine, n=13). The HRV of the 4 groups were compared. The correlations between HRV and the medication(s) used were clarified. Among the 4 groups, the AG had the lowest HRV with its total power (TP), very low frequency power (VLF) and low frequency power (LF) of HRV being significantly different from those of the other groups. Age and using quetiapine were found to be negatively correlated with TP, VLF and LF. With this study group, the autonomic effects of antidepressants were found not to be significant. Among psychiatric patients without psychotic symptoms, quetiapine causes an overt decrease in HRV.

show abstract

Heart Rate Variability During Antidepressant Treatment With Venlafaxine and Mirtazapine

Cited by 33 publications

References 6 publications

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

The Association Between Depressive Disorder and Cardiac Autonomic Control in Adults 60 Years and Older

The Effects of Antidepressants and Quetiapine on Heart Rate Variability

Contact Info

Product

Resources

About