Cited by 225Heart Rate Variability and Autonomic ControlCardiac Health and Mental HealthVagus Nerve Stimulation Research

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Longitudinal Evidence for Unfavorable Effects of Antidepressants on Heart Rate Variability

Licht, Carmilla M.M., de Geus, Eco J.C., van Dyck, Richard, Penninx, Brenda W.J.H.·2010·Biological Psychiatry

DOI 10.1016/j.biopsych.2010.06.032

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Abstract

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.

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Authors: Licht, C. M. M., de Geus, E. J. C., van Dyck, R., & Penninx, B. W. J. H.
Affiliations: Amsterdam Public Health (NL)
University Medical Center Groningen (NL)
Corresponding author: Licht, Carmilla M.M.
ORCID: Penninx, Brenda W.J.H.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2010-11
Volume: 68
Issue: 9
Pages: 861-868
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2010.06.032
OpenAlex: W2104647616
Cited by: 225
References: 64
Citations by year: 2026: 2 · 2025: 8 · 2024: 10 · 2023: 16 · 2022: 7 · 2021: 21 · 2020: 10 · 2019: 18 · 2018: 13 · 2017: 14 · 2016: 20 · 2015: 25 · 2014: 15 · 2013: 21 · 2012: 13
FWCI: 9.99
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
VU Research Portal (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Leiden Repository (Leiden University) (submittedVersion)
Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Funders: Netherlands Organisation for Health Research and Development (10-000-1002)
VU University Medical Center
GGZ inGeest
Arkin
Leiden University Medical Center
GGZ Rivierduinen
University Medical Center Groningen
Lentus
GGZ Friesland
GGZ Drenthe
Scientific Institute for Quality of Healthcare
Netherlands Institute for Health Services Research
Netherlands Institute of Mental Health and Addiction
Netherlands Organisation for Scientific Research (NWO) (917.66.320)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Keywords: antidepressants, heart rate variability, respiratory sinus arrhythmia, cardiac vagal control, tricyclic antidepressants, selective serotonin reuptake inhibitors, antidepressant discontinuation, autonomic function, heart rate, depression, anxiety
MeSH terms: Adolescent, Adult, Aged, Antidepressive Agents, Anxiety Disorders, Arrhythmia, Sinus, Depressive Disorder, Female, Heart Rate, Humans, Longitudinal Studies, Male, Middle Aged, Netherlands, Vagus Nerve

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Longitudinal Evidence for Unfavorable Effects of Antidepressants on Heart Rate Variability

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