Patterns of cardiorespiratory coordination in young women with recurrent major depressive disorder treated with escitalopram or venlafaxine.
Evidence from previous studies suggests autonomic dysregulation in patients with major depressive disorder (MDD). Antidepressant treatment may also affect central autonomic function. We investigated whether the type of antidepressant might be associated with the pattern of cardiorespiratory coordination in non-depressed women with recurrent MDD. Resting electrocardiograms and respiratory signals were simultaneously recorded from 38 euthymic women with recurrent MDD who were treated with either escitalopram (n=19) or venlafaxine (n=19) monotherapy and from 38 healthy women. Linear measures of heart rate variability were extracted to assess cardiac autonomic control. Sample entropy (SampEn) was computed to assess the complexity of heart rate and respiratory signals, and cross-SampEn was calculated to measure the nonlinear interaction of both signals. Significant decreases in the cardiovagal tone and cardiorespiratory coupling of women with recurrent MDD receiving venlafaxine, and tendencies toward lower cardiovagal tone and cardiorespiratory coupling in women with recurrent MDD receiving escitalopram were observed when compared with healthy controls. Effect sizes for these differences were large between women receiving venlafaxine and healthy controls. We found a positive association between cardiorespiratory decoupling and venlafaxine dose. Norepinephrine-enhancement, within a therapeutic dose range, seems to be closely associated with decreased vagal tone and reduced nonlinear coupling between heart rate and respiration in euthymic women with recurrent MDD. However, the effects of serotonin enhancement on cardiovagal tone should be considered. Our results suggest that the pharmacodynamic properties of antidepressants may affect autonomic regulation of women with recurrent MDD even in euthymic state.
Bipolar Disorder Translational Research Center & Department of Psychiatry, Seoul National University Bundang Hospital, 166 Gumi-Dong, Bundang-Gu, Seongnam, Gyeonggi 463-707, Republic of Korea.
Jae Seung
JS
Chang
Kyooseob
K
Ha
In-Young
IY
Yoon
Cheol Sung
CS
Yoo
Sang Hoon
SH
Yi
Ju Young
JY
Her
Tae Hyon
TH
Ha
Taesung
T
Park
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D001341:Autonomic Nervous System / Q000187:drug effects*; D016022:Case-Control Studies; D015283:Citalopram / Q000009:adverse effects* / Q000627:therapeutic use; D003511:Cyclohexanols / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D019277:Entropy; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D012008:Recurrence; D056152:Respiratory Rate / Q000187:drug effects / Q000502:physiology*; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D015283:Citalopram; D000069470:Venlafaxine Hydrochloride