Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis

Kemp, Andrew H., Quintana, Daniel S., Gray, Marcus A., Felmingham, Kim L., Brown, Kerri and Gatt, Justine M. (2010) Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biological Psychiatry, 67 11: 1067-1074. doi:10.1016/j.biopsych.2009.12.012


Author Kemp, Andrew H.
Quintana, Daniel S.
Gray, Marcus A.
Felmingham, Kim L.
Brown, Kerri
Gatt, Justine M.
Title Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis
Journal name Biological Psychiatry   Check publisher's open access policy
ISSN 0006-3223
1873-2402
Publication date 2010-06
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.biopsych.2009.12.012
Volume 67
Issue 11
Start page 1067
End page 1074
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Formatted abstract
Background: Depression is associated with an increase in the likelihood of cardiac events; however, studies investigating the relationship between depression and heart rate variability (HRV) have generally focused on patients with cardiovascular disease (CVD). The objective of the current report is to examine with meta-analysis the impact of depression and antidepressant treatment on HRV in depressed patients without CVD.
Methods: Studies comparing 1) HRV in patients with major depressive disorder and healthy control subjects and 2) the HRV of patients with major depressive disorder before and after treatment were considered for meta-analysis.
Results: Meta-analyses were based on 18 articles that met inclusion criteria, comprising a total of 673 depressed participants and 407 healthy comparison participants. Participants with depression had lower HRV (time frequency: Hedges' g = −.301, p < .001; high frequency: Hedges' g = −.293, p < .001; nonlinear: Hedges' g = −1.955, p = .05; Valsalva ratio: Hedges' g = −.712, p < .001) than healthy control subjects, and depression severity was negatively correlated with HRV (r = −.354, p < .001). Tricyclic medication decreased HRV, although serotonin reuptake inhibitors, mirtazapine, and nefazodone had no significant impact on HRV despite patient response to treatment.
Conclusions: Depression without CVD is associated with reduced HRV, which decreases with increasing depression severity, most apparent with nonlinear measures of HRV. Critically, a variety of antidepressant treatments do not resolve these decreases despite resolution of symptoms, highlighting that antidepressant medications might not have HRV-mediated cardioprotective effects and the need to identify individuals at risk among patients in remission.
Keyword Antidepressant
Autonomic
Depression
Heart-rate variability
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: Centre for Advanced Imaging Publications
 
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Created: Tue, 23 Oct 2012, 16:29:26 EST by Sandrine Ducrot on behalf of Centre for Advanced Imaging