title: Heart rate variability during antidepressant treatment with venlafaxine and mirtazapine.
abstract: 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.
authors.affiliation: *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.
authors.forename: Johannes
authors.initials: J
authors.lastname: Terhardt
authors.forename: Florian
authors.initials: F
authors.lastname: Lederbogen
authors.forename: Anne
authors.initials: A
authors.lastname: Feuerhack
authors.forename: Bettina
authors.initials: B
authors.lastname: Hamann-Weber
authors.forename: Maria
authors.initials: M
authors.lastname: Gilles
authors.forename: Claudia
authors.initials: C
authors.lastname: Schilling
authors.forename: Olivera
authors.initials: O
authors.lastname: Lecei
authors.forename: Michael
authors.initials: M
authors.lastname: Deuschle
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage*; D003511:Cyclohexanols / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008803:Mianserin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D000078785:Mirtazapine; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
chemical_list: D000928:Antidepressive Agents; D003511:Cyclohexanols; D008803:Mianserin; D000069470:Venlafaxine Hydrochloride; D000078785:Mirtazapine