title: The effects of venlafaxine on autonomic functions in healthy volunteers.
abstract: Antidepressants that block norepinephrine uptake may cause unwanted effects on autonomic functions such as reduction of heart rate variability. This randomized, double-blind, placebo-controlled study examined the effects of venlafaxine on heart rate variability, vasoconstrictory responses (VRs) of cutaneous blood vessels, and pupillary light reflex in humans. Twelve healthy male subjects aged 23 to 32 years (mean +/- SD, 26 +/- 3 years) orally received 37.5 mg of venlafaxine BID for 7 days and subsequently 75 mg BID for another 7 days. After a 14-day washout phase, placebo was administered to the subjects for 14 days under randomized double-blind crossover conditions. Heart rate variability was diminished, and the dilation phase of VR was prolonged during multiple dosing with venlafaxine (P < 0.05). A significant increase in resting pupil diameter, a decrease in amplitude, an increase in latency, and a shortening of the 33% recovery time of the pupillary light reflex were noted with the drug, whereas no changes were observed under placebo condition. Sustained VR and shortening of the recovery time of the pupillary light reflex are consistent with sympathetic potentiation resulting from noradrenaline reuptake blockade in cutaneous blood vessels and iris. The decrease in amplitude and increase in latency of the pupillary light reflex could be indicative of centrally mediated parasympathetic inhibition.
authors.affiliation: Institute of Clinical Pharmacology, Medical Faculty, Technical University, Fiedlerstrasse 27, Dresden, Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Siepmann
authors.forename: Tjalf
authors.initials: T
authors.lastname: Ziemssen
authors.forename: Michael
authors.initials: M
authors.lastname: Mueck-Weymann
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Kirch
authors.forename: Martin
authors.initials: M
authors.lastname: Siepmann
mesh_terms: D000284:Administration, Oral; D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D000328:Adult; D000704:Analysis of Variance; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000502:physiology; D002214:Capsules; D003511:Cyclohexanols / Q000008:administration & dosage / Q000494:pharmacology*; D004562:Electrocardiography / Q000379:methods; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods; D016018:Least-Squares Analysis; D008297:Male; D012025:Reflex, Pupillary / Q000187:drug effects / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D012867:Skin / Q000098:blood supply / Q000187:drug effects; D013997:Time Factors; D014661:Vasoconstriction / Q000187:drug effects; D000069470:Venlafaxine Hydrochloride
chemical_list: D018759:Adrenergic Uptake Inhibitors; D002214:Capsules; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride