Terhardt Johannes, Lederbogen Florian, Feuerhack Anne, Hamann-Weber Bettina, Gilles Maria, Schilling Claudia, Lecei Olivera, Deuschle Michael
*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.
Clin Neuropharmacol. 2013 Nov-Dec;36(6):198-202. doi: 10.1097/WNF.0b013e3182a76fbb.
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.
心率变异性（HRV）反映心脏自主神经调节，HRV降低被认为是抑郁症与心血管死亡率之间的病理生理联系。到目前为止，关于文拉法辛和米氮平对HRV影响的信息有限。我们研究了28名非抑郁对照者和41名接受文拉法辛（n = 20）和米氮平（n = 21）治疗的中度抑郁症患者。在6天洗脱期后以及治疗14天和28天后，测量仰卧位和直立位的心率、血压和HRV。我们发现与非抑郁对照者相比，抑郁症患者心率增加且HRV降低。此外，治疗期间HRV总功率下降。4周后的药物治疗和缓解状态与HRV的变化无关。我们得出结论，抑郁症与HRV降低有关，这可能反映了交感迷走神经失衡。广泛使用的抗抑郁药文拉法辛和米氮平导致HRV进一步下降。临床医生在选择抗抑郁药时应考虑HRV的影响。
