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Title: Longitudinal Evidence for Unfavorable Effects of Antidepressants on Heart Rate Variability
Author(s): C.M. Licht, E.J. De Geus, R.V. Dyck and B.W. Penninx
Journal: Biol.Psychiatry
Year: 2010
Pages: --
Publisher address: Department of Psychiatry and EMGO Institute for Health and Care Research, VU Univwersity Medical Center (VUmc), Amsterdam, The Netherlands
File URL: vuams-pubs/Licht_2010.pdf
Keywords: antidepressant, ANTIDEPRESSANTS, Anxiety, Depression, Female, Heart, Heart Rate, heart rate variability, HEART-RATE, HEART-RATE-VARIABILITY, LEVEL, Longitudinal Studies, methods, Netherlands, psychiatry, RATE-VARIABILITY, Research, RESPIRATORY SINUS ARRHYTHMIA, Time, VARIABILITIES, VARIABILITY
Abstract: BACKGROUND:: It was previously shown that antidepressants are associated with diminished vagal control over the heart. Longitudinal studies are needed to test the causality of this association further. METHODS:: Longitudinal data were obtained in the Netherlands Study of Depression and Anxiety. At baseline and at 2-year follow-up, heart rate and cardiac vagal control as indexed by respiratory sinus arrhythmia were measured in 2114 subjects (mean age = 42.0 years; 66.2% female), who either used antidepressants at one or two time points (n = 603) or did not use antidepressants at any time point (n = 1511). Linear mixed-model analyses were conducted to compare changes in respiratory sinus arrhythmia and heart rate over time across antidepressant-naive subjects, subjects who started using an antidepressant during follow-up, subjects who stopped using an antidepressant, and persistent antidepressant users. Analyses were adjusted for demographics, health, and lifestyle factors. RESULTS:: Compared with continuous nonusers, subjects who started the use of a tricyclic antidepressant or a serotonergic and noradrenergic antidepressant showed a significantly greater increase in heart rate and a decrease of respiratory sinus arrhythmia at 2 years. Subjects who started the use of selective serotonin reuptake inhibitors also showed a decrease in respiratory sinus arrhythmia, but their heart rate did not increase. Discontinuing antidepressants systematically caused opposite effects; levels returned in the direction of those observed among nonusers. CONCLUSIONS:: These 2-year longitudinal results indicate that all antidepressants cause a decrease in cardiac vagal control. After discontinuing antidepressants, autonomic function recovers, suggesting that the unfavorable effects are (partly) reversible

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