NDLI: Heart rate variability in major depressive disorder and after antidepressant treatment with agomelatine and paroxetine: Findings from the Taiwan Study of Depression and Anxiety (TAISDA).

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Heart rate variability in major depressive disorder and after antidepressant treatment with agomelatine and paroxetine: Findings from the Taiwan Study of Depression and Anxiety (TAISDA).

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Heart rate variability in major depressive disorder and after antidepressant treatment with agomelatine and paroxetine: Findings from the Taiwan Study of Depression and Anxiety (TAISDA).

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yeh, Ta-Chuan Kao, Lien-Cheng Tzeng, Nian-Sheng Kuo, Terry B. J. Huang, San-Yuan Chang, Chuan-Chia Chang, Hsin-An
Spatial Coverage	Taiwan
Description	Country affiliation: Taiwan Author Affiliation: Yeh TC ( Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.); Kao LC ( Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.); Tzeng NS ( Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan); Kuo TB ( Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.); Huang SY ( Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.); Chang CC ( Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.); Chang HA ( Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: chang.ha@mail.ndmctsgh.edu.tw.)
Abstract	Evidence from previous studies suggests that heart rate variability (HRV) is reduced in major depressive disorder (MDD). However, whether this reduction is attributable to the disorder per se or to medication, since antidepressants may also affect HRV, is still debated. There is a dearth of information regarding the effects of agomelatine, a novel antidepressant, on HRV. Here, we investigated whether HRV is reduced in MDD and compared the effects of agomelatine and paroxetine on HRV. We recruited 618 physically healthy unmedicated patients with MDD and 506 healthy volunteers aged 20-65 years. Frequency-domain measures of resting HRV were obtained at the time of enrollment for all participants. For patients with MDD, these measures were obtained again after 6 weeks of either agomelatine or paroxetine monotherapy. Compared with healthy subjects, unmedicated patients with MDD exhibited significantly lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV, and a higher LF/HF ratio. Depression severity independently contributed to decreased HRV and vagal tone. Fifty-six patients completed the open-label trial (n=29 for agomelatine, n=27 for paroxetine). Between-group analyses showed a significant group-by-time interaction for LF-HRV and HF-HRV, driven by increases in LF-HRV and HF-HRV only after agomelatine treatment. Within the paroxetine-treated group, there were no significant changes in mean R-R intervals or any HRV indices. We therefore concluded that MDD is associated with reduced HRV, which is inversely related to depression severity. Compared with paroxetine, agomelatine has a more vagotonic effect, suggesting greater cardiovascular safety. Clinicians should consider HRV effects while selecting antidepressants especially for depressed patients who already have decreased cardiac vagal tone.
File Format	HTM / HTML
ISSN	02785846
Volume Number	64
e-ISSN	18784216
Journal	Progress in Neuro-Psychopharmacology and Biological Psychiatry
Language	English
Publisher	Elsevier
Publisher Date	2016-01-04
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Psychiatry Acetamides Therapeutic Use Antidepressive Agents Depressive Disorder, Major Drug Therapy Physiopathology Heart Rate Drug Effects Paroxetine Adverse Effects Adult Aged Blood Pressure Physiology Cardiovascular Agents Case-control Studies Epidemiology Female Humans Male Middle Aged Psychiatric Status Rating Scales Regression Analysis Rest Severity Of Illness Index Taiwan Young Adult Clinical Trial Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Biological Psychiatry Pharmacology

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