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Effects of Depression, Anxiety, Comorbidity, and Antidepressants on Resting-State Heart Rate and Its Variability: An ELSA-Brasil Cohort Baseline Study
Abstract
OBJECTIVE: Increases in resting-state heart rate and decreases in its variability are associated with substantial morbidity and mortality, yet contradictory findings have been reported for the effects of the mood and anxiety disorders and of antidepressants. The authors investigated heart rate and heart rate variability in a large cohort from Brazil, using propensity score weighting, a relatively novel method, to control for numerous potential confounders. METHOD: A total of 15,105 participants were recruited in the Brazilian Longitudinal Study of Adult Health. Mood and anxiety disorders were ascertained using the Portuguese version of the Clinical Interview Schedule-Revised. Heart rate and its variability were extracted from 10-minute resting-state electrocardiograms. Regressions weighted by propensity scores were carried out to compare participants with and without depressive or anxiety disorders, as well as users and non-users of antidepressants, on heart rate and heart rate variability. RESULTS: Use of antidepressants was associated with increases in heart rate and decreases in its variability. Effects were most pronounced for the tricyclic antidepressants (Cohen's d, 0.72-0.81), followed by serotonin and norepinephrine reuptake inhibitors (Cohen's d, 0.42-0.95) and other antidepressants (Cohen's d, 0.37-0.40), relative to participants not on antidepressants. Only participants with generalized anxiety disorder showed robust, though small, increases in heart rate and decreases in its variability after propensity score weighting. CONCLUSIONS: The findings may, in part, underpin epidemiological findings of increased risk for cardiovascular morbidity and mortality. Many factors that have an adverse impact on cardiac activity were controlled for in this study, highlighting the importance of cardiovascular risk reduction strategies. Further study is needed to examine whether, how, and when such effects contribute to morbidity and mortality.
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“Novel analytical methods such as propensity score weighting using generalized boosted modeling may help to overcome the limitations of traditional analysis (e.g., Kemp et al., 2014), but are yet to be applied to associations between HRV and wellbeing.”
From The Complex Construct of Wellbeing and the Role of Vagal Function (2022) · cites this paper as Kemp et al., 2014
In the citing paper
“Interestingly, the basal heart rate was lower in patients taking SSRIs (mean=65.40 bpm, p=0.003, d=0.161) than in patients taking the placebo (Table 1).”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [28]
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Heart rate variability as a transdiagnostic biomarker of psychopathology
Beauchaine, T. P., & Thayer, J. F. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.08.004 · Cited by 870
“Evidence for low HF-HRV in internalizing disorders is abundant though not universal (e.g., Pittig et al., 2013; Kemp et al., 2014; Licht et al., 2009).”
InfluentialSelf-citationCarvalho, A. F., Sharma, M. S., Brunoni, A. R., Vieta, E., & Fava, G. A. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447034 · Cited by 650
Self-citationDepression and cardiovascular disease: Epidemiological evidence on their linking mechanisms
Penninx, B. W. J. H. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.07.003 · Cited by 576
“Two other recent large-scale studies by Licht et al. (2015) and Kemp et al. (2014) did also not confirm an association between depression and lower HRV.”
InfluentialPhysiological concomitants of perseverative cognition: A systematic review and meta-analysis.
Ottaviani, C., Thayer, J. F., Verkuil, B., Lonigro, A., Medea, B., Couyoumdjian, A., & Brosschot, J. F. (2016) · Psychological Bulletin · doi:10.1037/bul0000036 · Cited by 476
“This would have acted as an important confounding in our meta-analysis, especially in light of the recognized effects of antidepressants on physiological responses such as heart rate and heart rate variability (e.g., Kemp et al., 2014).”
Self-citationFuture Directions in Emotion Dysregulation and Youth Psychopathology
Beauchaine, T. P. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2015.1038827 · Cited by 394
“…Beauchaine, Mead, & GatzkeKopp, 2009), and with a wide range of psychopathological outcomes, including anxiety (e.g., Hastings et al., 2008; Kemp et al., 2014; Thayer, Friedman, & Borkovec, 1996), phobias (e.g., Åhs, Sollers, Furmark, Fredrikson, & Thayer, 2009), attention problems (see…”
Vaccarino, V., Badimon, L., Bremner, J. D., Cenko, E., Cubedo, J., Dorobantu, M., Duncker, D. J., Koller, A., Manfrini, O., Milicic, D., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehy913 · Cited by 404
“Part of the effect may be driven by antidepressant medications.(136,137,139,140) Furthermore, the link between depression and HRV is likely bidirectional,(140) and depression and HRV may also share a genetic substrate, suggesting shared neurobiological alterations pre-disposing to both depression and autonomic dysfunc…”
BackgroundAddressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review
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“They also decreased heart rate variability (HRV).(28) These negative effects were highest in TCAs (mean=73.”
BackgroundKoenig, J., Kemp, A. H., Beauchaine, T. P., Thayer, J. F., & Kaess, M. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.04.013 · Cited by 285
Self-citationSakaki, M., Yoo, H. J., Nga, L., Lee, T., Thayer, J. F., & Mather, M. (2016) · NeuroImage · doi:10.1016/j.neuroimage.2016.05.076 · Cited by 271
“As discussed earlier, lower resting HRV has been associated with depression (Kemp et al., 2010), as well as state and trait anxiety (Kemp et al., 2014; Thayer et al., 1996).”
InfluentialSelf-citationYoung, H. A., & Benton, D. (2018) · Behavioural Pharmacology · doi:10.1097/fbp.0000000000000383 · Cited by 249
“The vast majority of research linking health and HRV has focused on tonic resting-state HRV (Chalmers et al., 2014; Kemp et al., 2014, 2016).”
BackgroundGuidelines for wrist-worn consumer wearable assessment of heart rate in biobehavioral research
Nelson, B. W., Low, C. A., Jacobson, N., Areán, P., Torous, J., & Allen, N. B. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0297-4 · Cited by 241
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Ethnic Differences in Resting Heart Rate Variability
Hill, L. K., Hu, D. D., Koenig, J., Sollers, J. J., Kapuku, G. K., Wang, X., Snieder, H., & Thayer, J. F. (2015) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000133 · Cited by 203
“Similarly, the effects of medication have been consistently shown to influence HRV levels (58).”
BackgroundSelf-citationTsui-Caldwell, Y. H. W., & Steffen, P. R. (2018) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2018.01.001 · Cited by 188
Shader, T. M., Gatzke‐Kopp, L. M., Crowell, S. E., Reid, M. J., Thayer, J. F., Vasey, M. W., Webster-Stratton, C. H., Bell, Z. E., & Beauchaine, T. P. (2017) · Development and Psychopathology · doi:10.1017/s0954579417000669 · Cited by 165
“These include anxiety disorders (e.g., Hastings, Nuselovici, et al., 2008; Hastings, Sullivan, et al., 2008; Kemp et al., 2014; Thayer, Friedman, & Borkovec, 1996), attention problems (see Rash & Aguirre-Camacho, 2012), autism (Neuhaus, Bernier, & Beauchaine, 2014; Patriquin, Scarpa, Friedman, & Porges, 2013), bipolar…”
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Resting state vagal tone in borderline personality disorder: A meta-analysis
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“Reduced vmHRV relative to controls is reported in major depressive disorder (MDD) (Kemp et al., 2010) and MDD with comorbid generalized anxiety disorder (Kemp et al., 2012), as well as MDD with melancholia (Kemp et al., 2014).”
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“There is epidemiological evidence that the depression–HRV relationship is partly or fully driven by use of antidepressants (Licht et al. 2008, 2010; Kemp et al. 2014; O’Regan et al. 2015).”
BackgroundHeart rate variability in bipolar disorder: A systematic review and meta-analysis
Faurholt‐Jepsen, M., Kessing, L. V., & Munkholm, K. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.12.007 · Cited by 120
“Of these, 17 articles were excluded from review due to 1) not including patients with bipolar disorder (Clamor et al., 2014; Kemp et al., 2014) 2) being a review or comment (Voss et al., 2006) 3) no raw data on mean HRV available (de Pereira et al., 2015), 4) presenting duplicate data (Clarke,…”
BackgroundKemp, A. H., Koenig, J., & Thayer, J. F. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.09.006 · Cited by 114
“While it is possible that these persistent reductions in HRV relate to the impact of medications including antidepressants (Kemp et al., 2010; Kemp et al., 2014a; Licht et al., 2010) and medications with anticholinergic effects (often prescribed for hypertension and cardiovascular disease) we…”
BackgroundResultInfluentialA literature review of heart rate variability in depressive and bipolar disorders
Bassett, D. L. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415622689 · Cited by 113
“Subsequently, Kemp et al. (2010) performed a meta-analysis of 18 studies, which examined HRV in 673 patients with MDD and 407 healthy control subjects.”
MethodLin, I., Fan, S., Yen, C., Yeh, Y., Tang, T., Huang, M., Liu, T., Wang, P., Lin, H., Tsai, H.-Y., et al. (2019) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2019.17.2.222 · Cited by 139
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Chalmers, J. A., Heathers, J. A. J., Abbott, M. J., Kemp, A. H., & Quintana, D. S. (2016) · BMC Psychology · doi:10.1186/s40359-016-0138-z · Cited by 102
“These findings were also complimented by strong and substantial evidence from Bayesian analyses, and provide convergent support for results from past studies, which have indicated that generalised anxiety disorder may be characterised by the most robust reductions in HRV [26, 49].”
BackgroundResultSelf-citationKemp, A. H., Quintana, D. S., Quinn, C. R., Hopkinson, P., & Harris, A. W. F. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.01387 · Cited by 95
“However, not all studies (Licht et al., 2008) – including our own (Kemp et al., 2014) – have reported reduced HRV in depressed patients highlighting the complexity of this issue.”
BackgroundMethodInfluentialSelf-citationLatvala, A., Kuja-Halkola, R., Rück, C., D’Onofrio, B. M., Jernberg, T., Almqvist, C., Mataix-Cols, D., Larsson, H., & Lichtenstein, P. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.2717 · Cited by 82
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Self-citationVagally mediated heart rate variability in headache patients—a systematic review and meta-analysis
Koenig, J., Williams, D. P., Kemp, A. H., & Thayer, J. F. (2015) · Cephalalgia · doi:10.1177/0333102415583989 · Cited by 81
Self-citationDifferences of sympathetic and parasympathetic modulation in major depression
Schumann, A., Andrack, C., & Bär, K. (2017) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2017.07.009 · Cited by 79
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“In some cases, antidepressant use, rather than depression per se, was found to be associated with reduced HRV (Kemp et al., 2014; Licht et al., 2008; Licht, de Geus, van Dyck, & Penninx, 2010).”
BackgroundResultAssociation of Depressive Symptoms and Heart Rate Variability in Vietnam War–Era Twins
Huang, M., Shah, A. J., Su, S., Goldberg, J. H., Lampert, R. J., Levantsevych, O. M., Shallenberger, L. H., Pimple, P. M., Bremner, J. D., & Vaccarino, V. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.0747 · Cited by 76
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“Participants on medications including angiotensin-converting enzyme inhibitors, antiarrhythmics, beta blockers, diuretics and sympathetic agonists (Felber et al., 2006), and antidepressants (Kemp et al., 2010, 2014) were also excluded from the present analysis.”
BackgroundInfluentialSelf-citationYeh, T., Kao, L.-C., Tzeng, N., Kuo, T. B. J., Huang, S., Chang, C.-C., & Chang, H. (2015) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2015.07.007 · Cited by 72
The Different Facets of Heart Rate Variability in Obstructive Sleep Apnea
Qin, H., Steenbergen, N., Glos, M., Wessel, N., Kraemer, J. F., Vaquerizo-Villar, F., & Penzel, T. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.642333 · Cited by 75
Heart rate variability: Evaluating a potential biomarker of anxiety disorders
Tomasi, J., Zai, C. C. H., Pouget, J. G., Tiwari, A. K., & Kennedy, J. L. (2023) · Psychophysiology · doi:10.1111/psyp.14481 · Cited by 66
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“large cohort study in 2014 reached the contradictory conclusion that only GAD with small effect sizes and not depression or comorbid depression and anxiety disorder were associated with decreased HRV (Kemp et al., 2014).”
BackgroundResultInfluentialBrunoni, A. R., Sampaio-Júnior, B., Moffa, A. H., Borrione, L., Nogueira, B. S., Aparicio, L. V. M., Veronezi, B. P., Moreno, M., Fernandes, R. A., Tavares, D. F., et al. (2015) · Sao Paulo Medical Journal · doi:10.1590/1516-3180.2014.00351712 · Cited by 59
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“Indeed, there is evidence that some anxiety disorders are associated with stronger decreases in HF-HRV than others [1, 32].”
BackgroundResultPhysical Exercise for Late-Life Depression: Effects on Heart Rate Variability
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“For example, he found lower RMSSD levels in subjects suffering from melancholia than in a nonmelancholic sample (Kemp et al., 2014b) and reduced RMSSD and HF values in depressed subjects with comorbid generalized anxiety as compared to MDD subjects without comorbid anxiety (Kemp et al., 2012).”
ResultSantos, I. S., Goulart, A. C., Brunoni, A. R., Kemp, A. H., Lotufo, P. A., & Benseñor, I. M. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.04.800 · Cited by 46
Self-citationA systematic review on heart rate variability in Bulimia Nervosa
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Self-citationResting state vagal tone in attention deficit (hyperactivity) disorder: A meta-analysis
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Self-citationReduced heart rate variability in remitted bipolar disorder and recurrent depression
Bassett, D. L., Bear, N., Nutt, D., Hood, S. D., Bassett, S., & Hans, D. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416652734 · Cited by 41
“Subsequently though, Kemp et al. (2014b) identified that the melancholic sub-type of depressive disorder was indeed associated with reduced HRV, in contrast to non-melancholic depression.”
BackgroundResultKemp, A. H., Koenig, J., Thayer, J. F., Bittencourt, M. S., Pereira, A. C., Santos, I. S., Dantas, E. M., Mill, J. G., Chor, D., Ribeiro, A. L. P., et al. (2016) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000359 · Cited by 41
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“…variability – a predictor of future mortality – is most reduced in MDD patients with GAD (Kemp et al., 2012), demonstrating the adverse effects of distinctive clinical features including a depressive episode, persistent worry, and hypervigilance on cardiac function (see also Kemp et al., 2014).”
BackgroundSelf-citationTomasi, J., Zai, C. C. H., Zai, G. C., Herbert, D., Richter, M. A., Mohiuddin, A. G., Tiwari, A. K., & Kennedy, J. L. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.137 · Cited by 37
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“We recently observed that the SSRIs are associated with a small decrease in HR and HRV (15).”
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“Latest research demonstrates associations with common mental disorders like depression [29].”
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Heart Rate Variability in Individual Psychotherapy
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“…Nerv Ment Dis 2019;207: 451–458) H eart rate variability (HRV) refers to the amount of variation in thetemporal distance between successive heartbeats and has been shown to be related with mental disorders and therapeutic outcome (Angelovski et al., 2016; Chalmers et al., 2014; Kemp et al., 2014).”
BackgroundChang, W. H., Lee, I. H., Chi, M. H., Lin, S., Chen, K. C., Chen, P. S., Chiu, N.-T., Yao, W. J., & Yang, Y. K. (2018) · Scientific Reports · doi:10.1038/s41598-018-20923-y · Cited by 34
Heart Rate Variability for the Prediction of Treatment Response in Major Depressive Disorder
Choi, K. W., & Jeon, H. J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00607 · Cited by 32
“On the contrary, their large-scale longitudinal study showed that SSRI, and serotonin and norepinephrine reuptake inhibitors decreased HRV parameters (82).”
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“For instance, concurrent comorbidities (neurological disorders, endocrine disorders, ophthalmic conditions, or cardiovascular pathology), medication use, caffeine or alcohol intake, or even sleep hygiene (Ayres et al. 2021; Kemp et al. 2014; Pichora-Fuller et al. 2016).”
BackgroundYoung, H. A., Cousins, A. L., Watkins, H., & Benton, D. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.12.001 · Cited by 31
Diminished autonomic neurocardiac function in patients with generalized anxiety disorder
Kim, K., Lee, S., & Kim, J. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s121533 · Cited by 31
“18,19”
InfluentialAssociations between symptoms of depression and heart rate variability: An exploratory study
Borrione, L., Brunoni, A. R., Sampaio-Júnior, B., Aparicio, L. V. M., Kemp, A. H., Benseñor, I. M., Lotufo, P. A., & Fráguas, R. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.028 · Cited by 31
Self-citationKim, J.-M., Lee, J., Shin, C. M., Lee, D. H., & Park, B. (2015) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2015-000133 · Cited by 30
Kemp, A. H., López, S. R., Passos, V. M. D. A., Bittencourt, M. S., Dantas, E. M., Mill, J. G., Ribeiro, A. L. P., Thayer, J. F., Benseñor, I. M., & Lotufo, P. A. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.04.006 · Cited by 31
“We have described the artefact detection and spectral analytic techniques previously (Dantas et al., 2012; Kemp et al., 2014a).”
BackgroundMethodSelf-citationMulticentric evidence of emotional impairments in hypertensive heart disease
Yoris, A., Legaz, A., Abrevaya, S., Alarco, S., Peláez, J. L., Sanchez, R. A., García, A. M., Ibáñez, A. M., & Sedeño, L. (2020) · Scientific Reports · doi:10.1038/s41598-020-70451-x · Cited by 27
Bupleurum in Treatment of Depression Disorder: A Comprehensive Review
Ran, S., Peng, R., Guo, Q., Cui, J., Chen, G., & Wang, Z. (2024) · Pharmaceuticals · doi:10.3390/ph17040512 · Cited by 26
Brunoni, A. R., Szlejf, C., Suemoto, C. K., Santos, I. S., Goulart, A. C., Viana, M. C., Koyanagi, A., Barreto, S. M., Moreno, A. B., Carvalho, A. F., et al. (2019) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13109 · Cited by 26
Self-citationPsycho-Cardiological Disease: A Bibliometric Review From 2001 to 2021
You, Y., Shou, X., Zhang, X., Fan, S., Chai, R., Xue, W., Hu, Y., & He, Q. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.890329 · Cited by 26
Treatment of affective disorders in cardiac disease
Mavrides, N. A., & Nemeroff, C. B. (2015) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2015.17.2/nmavrides · Cited by 25
Features of autonomic cardiovascular control during cognition in major depressive disorder
Bair, A., Marksteiner, J., Falch, R., Ettinger, U., del Paso, G. A. R., & Duschek, S. (2020) · Psychophysiology · doi:10.1111/psyp.13628 · Cited by 25
Nelson, B. W., Flannery, J., Flournoy, J. C., Duell, N., Prinstein, M. J., & Telzer, E. H. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13471 · Cited by 20
Chang, H., Fang, W., Wan, F.-J., Tzeng, N., Liu, Y., Shyu, J., Chang, T.-C., Huang, S., & Chang, C.-C. (2019) · Psychological Medicine · doi:10.1017/s0033291719001302 · Cited by 23
“Effect sizes are reported as Cohen’s d values; d < 0.2 is considered small, between 0.4 and 0.6, medium, and >0.8 large (Kemp et al., 2014).”
BackgroundResultInfluentialSadeghi, M., Sasangohar, F., McDonald, A. D., & Hegde, S. (2021) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1177/00187208211034024 · Cited by 23
“, 2015) and antidepressants (Kemp et al., 2014) on resting heart rate in the civilian population.”
BackgroundResultThe Complex Construct of Wellbeing and the Role of Vagal Function
Wilkie, L., Fisher, Z., & Kemp, A. H. (2022) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2022.925664 · Cited by 18
Self-citationChang, C.-C., Tzeng, N., Yeh, C., Kuo, T. B. J., Huang, S., & Chang, H. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1294765 · Cited by 20
“Tricyclic antidepressants (TCAs) are widely known to reduce parasympathetic tone and thus HRV (Kemp, et al. 2010; Kemp et al. 2014).”
BackgroundHeart rate variability predicts outcome of short‐term psychotherapy at the workplace
Balint, E. M., Daniele, V., Langgartner, D., Reber, S. O., Rothermund, E., Gündel, H., von Wietersheim, J., Buckley, T. A., & Jarczok, M. N. (2022) · Psychophysiology · doi:10.1111/psyp.14150 · Cited by 22
Autonomic complexity dynamically indexes affect regulation in everyday life.
Stange, J. P., Li, J., Xu, E. P., Ye, Z., Zapetis, S. L., Phanord, C. S., Wu, J., Sellery, P., Keefe, K., Forbes, E. E., et al. (2023) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000849 · Cited by 18
Magal, N., Rab, S. L., Goldstein, P., Simon, L., Jiryis, T., & Admon, R. (2022) · Chronic Stress · doi:10.1177/24705470221100987 · Cited by 18
Goulart, A. C., Santos, I. S., Bittencourt, M. S., Lotufo, P. A., & Benseñor, I. M. (2015) · Cephalalgia · doi:10.1177/0333102415613611 · Cited by 18
“Finally, we considered all medication about migraine prophylaxis in our multivariable analyses, including drugs such as beta-blockers and antidepressants that could influence some cardiovascular outcomes (41).”
MethodSelf-citationCarnevali, L., Rivara, S., Nalivaiko, E., Thayer, J. F., Vacondio, F., Mor, M., & Sgoifo, A. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.04.013 · Cited by 18
“For example, AEA seems to protect the heart from arrhythmias induced by adrenaline (Ugdyzhekova et al., 2001) or by ischemia-reperfusion procedure (Krylatov et al., 2001).”
Self-citationFantini‐Hauwel, C., Batselé, É., Gois, C., & Noël, X. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00697 · Cited by 18
Komnenov, D., Quaal, H. L., & Rossi, N. F. (2020) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00245.2020 · Cited by 17
Reduced heart rate variability during mania in a repeated naturalistic observational study
Stautland, A., Jakobsen, P., Fasmer, O. B., Osnes, B., Tørresen, J., Nordgreen, T., & Oedegaard, K. J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1250925 · Cited by 18
Wu, X., Zhang, X., Sun, L., Lu, X., & Shen, C. (2023) · Cellular and Molecular Biology · doi:10.14715/cmb/2023.69.7.32 · Cited by 17
Pannu, A. S., & Goyal, R. K. (2024) · Current Drug Safety · doi:10.2174/0115748863301630240417071353 · Cited by 21
Santos, I. S., Bittencourt, M. S., Rocco, P., Pereira, A. C., Barreto, S. M., Brunoni, A. R., Goulart, A. C., Blaha, M. J., Lotufo, P. A., & Bensenor, I. M. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.04.048 · Cited by 17
Self-citationWeissman, D. G., Guyer, A. E., Ferrer, E. E., Robins, R. W., & Hastings, P. D. (2019) · Development and Psychopathology · doi:10.1017/s0954579419000646 · Cited by 19
“…development, including internalizing problems (Bylsma, Salomon, Taylor-Clift, Morris, & Rottenberg, 2014; Hastings, Kahle, & Nuselovici, 2014; Hastings et al., 2008; Kemp et al., 2014; Koenig, Kemp, Beauchaine, Thayer, & Kaess, 2016; Rottenberg, 2007; Rottenberg, Clift, Bolden, & Salomon, 2007).”
BackgroundTonello, L., Silva, I. O., Medeiros, A. R., Donato, A. N. A., Schuch, F. B., Donath, L., & Boullosa, D. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00192 · Cited by 17
“In the case of people with depression, the reduction of HRV has been demonstrated to be linked to the severity of the disease (15, 29, 89), with sympathetic predominance and reduction of parasympathetic activity, resulting in reduced HRV (86, 87).”
BackgroundKoenig, J., Jarczok, M. N., Fischer, J. E., & Thayer, J. F. (2015) · Pain Medicine · doi:10.1111/pme.12825 · Cited by 15
Self-citationGiurgi-Oncu, C., Tudoran, C., ENĂTESCU, V. R., Tudoran, M., Pop, G. N., & Bredicean, C. A. (2020) · Medicina · doi:10.3390/medicina56110590 · Cited by 13
Cardiovascular Variability and Reactivity in Major Depressive Disorder
Duschek, S., Bair, A., Hoffmann, A., Marksteiner, J., Montoro, C. I., & del Paso, G. A. R. (2021) · Journal of Psychophysiology · doi:10.1027/0269-8803/a000277 · Cited by 15
Strohman, A., Isaac, G., Payne, B., Verdonk, C., Khalsa, S. S., & Legon, W. (2024) · Clinical Neurophysiology · doi:10.1016/j.clinph.2024.09.006 · Cited by 20
Diminution of Heart Rate Variability in Bipolar Depression
Hage, B., Britton, B., Daniels, D., Heilman, K., Porges, S., & Halaris, A. (2017) · Frontiers in Public Health · doi:10.3389/fpubh.2017.00312 · Cited by 15
“More recent research has focused on specific medications, and it appears that tricyclic antidepressants (TCAs) are most robust in reducing HRV, followed by serotonin/norepinephrine reuptake inhibitors (46, 47).”
BackgroundEvaluation of low vagally-mediated heart rate variability as an early marker of depression risk
Watanabe, D. K., Jarczok, M. N., Williams, D. P., Koenig, J., & Thayer, J. F. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.051 · Cited by 16
Self-citationSeeley, S. H., Mennin, D. S., Aldao, A., McLaughlin, K. A., Rottenberg, J. A., & Fresco, D. M. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9744-y · Cited by 14
Kao, L.-C., Liu, Y.-W., Tzeng, N., Kuo, T. B. J., Huang, S., Chang, C.-C., & Chang, H. (2016) · Psychiatry Investigation · doi:10.4306/pi.2016.13.4.397 · Cited by 13
Walter, F. A., Gathright, E. C., Redle, J. D., Gunstad, J., & Hughes, J. W. (2019) · Annals of Behavioral Medicine · doi:10.1093/abm/kaz006 · Cited by 13
Heart Rate Variability Predicts Treatment Outcome in Major Depression
(2017) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20170017 · Cited by 13
Behandlung der Depression bei koronarer Herzerkrankung
Agorastos, A., Lederbogen, F., & Otte, C. (2015) · Der Nervenarzt · doi:10.1007/s00115-014-4162-z · Cited by 12
“orthostatische Dysregulation, verlängertes QTc-Interval, AV-Blockierung, reduzierte HRV, erhöhte Inzidenz von plötzlichem Herztod; [12, 42, 51]) als auch auf Inflammations- und metabolische Parameter [61, 62].”
Background
Metadata
- Authors
- Kemp, A. H., Brunoni, A. R., Santos, I. S., Nunes, M. A., Dantas, E. M., Carvalho de Figueiredo, R., Pereira, A. C., Ribeiro, A. L. P., Mill, J. G., Andreão, R. V., Thayer, J. F., Benseñor, I. M., & Lotufo, P. A.
- Affiliations
- The University of Sydney (AU)
- From University Hospital and the Faculty of Medicine, University of São Paulo, São Paulo, Brazil; the School of Psychology and Discipline of Psychiatry, University of Sydney, Sydney, Australia; the Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; the Collegiate of Biological Sciences, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil; Campus Centro Oeste Dona Lindu, Federal University of São João Del-Rei, Brazil; the Laboratory of Genetics and...
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2014-12-01
- Volume
- 171
- Issue
- 12
- Pages
- 1328-1334
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2119976990
- Cited by
- 189
- References
- 41
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 11 · 2023: 17 · 2022: 13 · 2021: 18 · 2020: 15 · 2019: 18 · 2018: 14 · 2017: 16 · 2016: 27 · 2015: 24 · 2014: 2
- FWCI
- 15.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- resting heart rate, heart rate variability, depression, anxiety disorders, antidepressants, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, generalized anxiety disorder, cardiovascular risk, mood disorders, ELSA-Brasil
- MeSH terms
- Adult, Aged, Antidepressive Agents, Antidepressive Agents, Tricyclic, Anxiety, Anxiety Disorders, Brazil, Cardiovascular Diseases, Depression, Major Depressive Disorder, Female, Heart Rate, Humans, Interview, Psychological, Longitudinal Studies, Male, Middle Aged, Vagus Nerve, Comorbidity, Selective Serotonin Reuptake Inhibitors, Adrenergic Uptake Inhibitors, Mood Disorders, Propensity Score
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