Heart rate variability during antidepressant treatment with venlafaxine and mirtazapine. 2013

Johannes Terhardt, and Florian Lederbogen, and Anne Feuerhack, and Bettina Hamann-Weber, and Maria Gilles, and Claudia Schilling, and Olivera Lecei, and Michael Deuschle
*Central Institute of Mental Health, University of Heidelberg, Faculty of Medicine Mannheim, Mannheim, Germany; and † Department of Psychiatry and Psychotherapy, University Medical Center, University of Freiburg, Freiburg, Germany.

Heart rate variability (HRV) reflects the cardiac autonomic regulation, and reduced HRV is considered a pathophysiological link between depression and cardiovascular mortality. So far, there is only limited information on the effects of venlafaxine and mirtazapine on HRV.We studied 28 nondepressed controls and 41 moderately depressed patients being treated with venlafaxine (n = 20) and mirtazapine (n = 21). Heart rate, blood pressure, and HRV were measured after a 6-day washout as well as after 14 and 28 days of treatment in supine and upright position.We found increased heart rate and reduced HRV in the depressed patients compared with the nondepressed controls. Moreover, HRV total power declined during the treatment period. Medication and remission status after 4 weeks were not related to the change in HRV.We conclude that depression is related to reduced HRV, which might reflect sympathovagal dysbalance. The widely used antidepressants venlafaxine and mirtazapine led to further decline in HRV. Clinicians should consider HRV effects in the selection of antidepressants.

UI MeSH Term Description Entries
D008297 Male Males
D008803 Mianserin A tetracyclic compound with antidepressant effects. It may cause drowsiness and hematological problems. Its mechanism of therapeutic action is not well understood, although it apparently blocks alpha-adrenergic, histamine H1, and some types of serotonin receptors. Lerivon,Mianserin Hydrochloride,Mianserin Monohydrochloride,Org GB 94,Tolvon,Hydrochloride, Mianserin,Monohydrochloride, Mianserin
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003511 Cyclohexanols Monohydroxy derivatives of cyclohexanes that contain the general formula R-C6H11O. They have a camphorlike odor and are used in making soaps, insecticides, germicides, dry cleaning, and plasticizers. Cyclohexanol
D003865 Depressive Disorder, Major Disorder in which five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Symptoms include: depressed mood most of the day, nearly every daily; markedly diminished interest or pleasure in activities most of the day, nearly every day; significant weight loss when not dieting or weight gain; Insomnia or hypersomnia nearly every day; psychomotor agitation or retardation nearly every day; fatigue or loss of energy nearly every day; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness, nearly every day; or recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. (DSM-5) Depression, Involutional,Major Depressive Disorder,Melancholia, Involutional,Paraphrenia, Involutional,Psychosis, Involutional,Depressive Disorders, Major,Involutional Depression,Involutional Melancholia,Involutional Paraphrenia,Involutional Paraphrenias,Involutional Psychoses,Involutional Psychosis,Major Depressive Disorders,Paraphrenias, Involutional,Psychoses, Involutional
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069470 Venlafaxine Hydrochloride A cyclohexanol and phenylethylamine derivative that functions as a SEROTONIN AND NORADRENALINE REUPTAKE INHIBITOR (SNRI) and is used as an ANTIDEPRESSIVE AGENT. 1-(2-(dimethylamino)-1-(4-methoxyphenyl)ethyl)cyclohexanol HCl,Cyclohexanol, 1-(2-(dimethylamino)-1-(4-methoxyphenyl)ethyl)-, hydrochloride,Dobupal,Efexor,Effexor,Sila-Venlafaxine,Trevilor,Vandral,Venlafaxine,Wy 45030,Wy-45,030,Wy-45030,Hydrochloride, Venlafaxine,Sila Venlafaxine,Wy 45,030,Wy45,030,Wy45030

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