BACKGROUND: It was previously shown that antidepressants are associated with diminished vagal control over the heart. Longitudinal studies are needed to test the causality of this association further. METHODS: Longitudinal data were obtained in the Netherlands Study of Depression and Anxiety. At baseline and at 2-year follow-up, heart rate and cardiac vagal control as indexed by respiratory sinus arrhythmia were measured in 2114 subjects (mean age = 42.0 years; 66.2% female), who either used antidepressants at one or two time points (n = 603) or did not use antidepressants at any time point (n = 1511). Linear mixed-model analyses were conducted to compare changes in respiratory sinus arrhythmia and heart rate over time across antidepressant-naive subjects, subjects who started using an antidepressant during follow-up, subjects who stopped using an antidepressant, and persistent antidepressant users. Analyses were adjusted for demographics, health, and lifestyle factors. RESULTS: Compared with continuous nonusers, subjects who started the use of a tricyclic antidepressant or a serotonergic and noradrenergic antidepressant showed a significantly greater increase in heart rate and a decrease of respiratory sinus arrhythmia at 2 years. Subjects who started the use of selective serotonin reuptake inhibitors also showed a decrease in respiratory sinus arrhythmia, but their heart rate did not increase. Discontinuing antidepressants systematically caused opposite effects; levels returned in the direction of those observed among nonusers. CONCLUSIONS: These 2-year longitudinal results indicate that all antidepressants cause a decrease in cardiac vagal control. After discontinuing antidepressants, autonomic function recovers, suggesting that the unfavorable effects are (partly) reversible.
BACKGROUND: It was previously shown that antidepressants are associated with diminished vagal control over the heart. Longitudinal studies are needed to test the causality of this association further. METHODS: Longitudinal data were obtained in the Netherlands Study of Depression and Anxiety. At baseline and at 2-year follow-up, heart rate and cardiac vagal control as indexed by respiratory sinus arrhythmia were measured in 2114 subjects (mean age = 42.0 years; 66.2% female), who either used antidepressants at one or two time points (n = 603) or did not use antidepressants at any time point (n = 1511). Linear mixed-model analyses were conducted to compare changes in respiratory sinus arrhythmia and heart rate over time across antidepressant-naive subjects, subjects who started using an antidepressant during follow-up, subjects who stopped using an antidepressant, and persistent antidepressant users. Analyses were adjusted for demographics, health, and lifestyle factors. RESULTS: Compared with continuous nonusers, subjects who started the use of a tricyclic antidepressant or a serotonergic and noradrenergic antidepressant showed a significantly greater increase in heart rate and a decrease of respiratory sinus arrhythmia at 2 years. Subjects who started the use of selective serotonin reuptake inhibitors also showed a decrease in respiratory sinus arrhythmia, but their heart rate did not increase. Discontinuing antidepressants systematically caused opposite effects; levels returned in the direction of those observed among nonusers. CONCLUSIONS: These 2-year longitudinal results indicate that all antidepressants cause a decrease in cardiac vagal control. After discontinuing antidepressants, autonomic function recovers, suggesting that the unfavorable effects are (partly) reversible.
Authors: Kate M Scott; Peter de Jonge; Jordi Alonso; Maria Carmen Viana; Zhaorui Liu; Siobhan O'Neill; Sergio Aguilar-Gaxiola; Ronny Bruffaerts; Jose Miguel Caldas-de-Almeida; Dan J Stein; Giovanni de Girolamo; Silvia E Florescu; Chiyi Hu; Nezar Ismet Taib; Jean-Pierre Lépine; Daphna Levinson; Herbert Matschinger; Maria Elena Medina-Mora; Marina Piazza; José A Posada-Villa; Hidenori Uda; Bogdan J Wojtyniak; Carmen C W Lim; Ronald C Kessler Journal: Int J Cardiol Date: 2013-08-15 Impact factor: 4.164
Authors: Vanessa Panaite; Alexandra Cowden Hindash; Lauren M Bylsma; Brent J Small; Kristen Salomon; Jonathan Rottenberg Journal: Int J Psychophysiol Date: 2015-12-08 Impact factor: 2.997
Authors: Andrew H Kemp; Tim Outhred; Sasha Saunders; Andre R Brunoni; Pradeep J Nathan; Gin S Malhi Journal: Psychopharmacology (Berl) Date: 2013-12-15 Impact factor: 4.530
Authors: Linn K Kuehl; Christoph Muhtz; Kim Hinkelmann; Lucia Dettenborn; Katja Wingenfeld; Carsten Spitzer; Christian Otte Journal: Psychopharmacology (Berl) Date: 2016-07-27 Impact factor: 4.530
Authors: Maria Ines Quintana; Sergio Baxter Andreoli; Marcela Poctich Peluffo; Wagner Silva Ribeiro; Marcelo M Feijo; Rodrigo Affonseca Bressan; Evandro S F Coutinho; Jair de Jesus Mari Journal: PLoS One Date: 2015-08-07 Impact factor: 3.240