title: Effects of citalopram on heart rate variability in women with generalized anxiety disorder.
abstract: BACKGROUND
  Heart rate variability (HRV) is defined as variations in R-R interval with time. Dysautonomia is common in patients with psychiatric disorders such as depression and anxiety. Using HRV analysis, recent studies showed that in anxiety disorders, the vagal cardiac function decreases, and sympathetic function increases. This study aimed at investigating citalopram effects on HRV.
  
  
  METHODS
  This before and after study was conducted in 25 generalized anxiety disorder (GAD) patients. GAD was diagnosed based on clinical interview according to diagnostic and statistical manual of mental disorders IV-Text revised (DSM-IV-TR) criteria using Structured Clinical Interview for DSM Disorders-I questionnaire. A cardiologist studied 24 h ambulatory monitoring of the electrocardiogram (Holter) on all patients before the treatment. A volume of 20 mg of citalopram was administered to the subjects on a daily basis. Then, they were studied by Holter monitoring again after 1-month of administration of citalopram.
  
  
  RESULTS
  The average age of participants was 35.32 ± 8.7. The average Holter monitoring time was 23.29 ± 1.14 h before treatment and 23.81 ± 0.68 after it. The 3 h low frequency/high frequency ratio was significantly different between 3 h segments of time before treatment (P < 0.001). This difference was even higher after treatment (P = 0.001). Data showed an increase in parasympathetic tone during sleep both before and after treatment.
  
  
  CONCLUSIONS
  These patients showed some impairments of HRV indices that did not improve by citalopram in future, the clinical importance of such disturbances should be evaluated in details with prolonged follow-up and greater sample size.
authors.affiliation: Associate Professor, Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Ranjbar
authors.affiliation: Associate Professor, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Akbarzadeh
authors.affiliation: Resident, Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Faramarz
authors.initials: F
authors.lastname: Zakeri
authors.affiliation: Resident, Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Farahbakhsh
authors.affiliation: Assistant Professor, Department of Psychology, School of Psychology, University of Tabriz, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ali Nazari
keywords: Ambulatory Electrocardiography; Anxiety Disorders; Heart Rate