Autonomic correlates of antidepressant treatment using heart-rate variability analysis.
OBJECTIVE
To assess the 24-hour temporal-domain heart-rate variability correlates of treatment with fluoxetine or doxepin for depression.


METHODS
A randomized evaluation of fluoxetine and doxepin measured a 50% change in the Hamilton Depression Rating Scale (HDRS) score as a response to therapy and was correlated with measures of standard deviation of the mean of all 5-minute segments of normal electrocardiographic R-R intervals (SDANN), standard deviation of all normal R-R intervals (SDNN), root mean square of successive differences in R-R intervals (r-MSSD), and percentage difference between adjacent normal R-R intervals that are greater than 50 msec (pNN50) from 24-hour electrocardiogram (ECG) tapes.


RESULTS
Ten out of 14 patients responded. Response was associated with an increase in SDANN of 17% (P < 0.05). Nonresponse was associated with a 17% decrease in SDANN and a 22% decrease in SDNN (both P < 0.05). No other measures correlated with therapeutic response. No heart-rate variability (HRV) differences between the 2 drug therapies were observed.


CONCLUSIONS
Twenty-four-hour HRV measures may be useful in assessing response to antidepressant therapy.
Khaykin
Y
Y
Division of Cardiology, St Michael's Hospital, University of Toronto, Ontario.
Dorian
P
P
Baker
B
B
Shapiro
C
C
Sandor
P
P
Mironov
D
D
Irvine
J
J
Newman
D
D
D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001341:Autonomic Nervous System / Q000187:drug effects; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D004316:Doxepin / Q000627:therapeutic use*; D005473:Fluoxetine / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D004316:Doxepin; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors