Document Detail

Major depression with ischemic heart disease: effects of paroxetine and nortriptyline on long-term heart rate variability measures.
MedLine Citation:
PMID:  12242058     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Studies have linked depression to sudden death and serious cardiovascular events in patients with preexisting cardiac illness. Recent studies have shown decreased vagal function in cardiac patients with depression and depressed patients without cardiac illness. METHODS: We compared 20-hour, sleeping, and awake heart period variability measures using spectral analysis, fractal dimension, and symbolic dynamics in two patient groups with major depression and ischemic heart disease (mean age 59-60 years) before and after 6 weeks of paroxetine or nortriptyline treatment. RESULTS: Spectral measures showed decreases in awake and sleeping total power (TP: 0.0-0.5 Hz), ultra low frequency power (ULF: 0-0.0033 Hz), very low frequency power (VLF: 0.0033-0.04 Hz), and low-frequency power (LF: 0.04-0.15 Hz) for nortriptyline condition and a decrease in high-frequency power (HF: 0.15-0.5 Hz) for the awake condition in patients who received nortriptyline. A measure of nonlinear complexity, WC-100, significantly increased after paroxetine during the awake condition. CONCLUSIONS: These findings suggest that nortriptyline has stronger vagolytic effects on cardiac autonomic function compared with paroxetine, which is in agreement with previous clinical and preclinical reports. Paroxetine may have some cardio-protective effects, especially in cardiac patients.
Vikram K Yeragani; Vanessa Pesce; Anusha Jayaraman; Steven Roose
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Biological psychiatry     Volume:  52     ISSN:  0006-3223     ISO Abbreviation:  Biol. Psychiatry     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-20     Completed Date:  2002-12-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0213264     Medline TA:  Biol Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  418-29     Citation Subset:  IM    
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA.
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MeSH Terms
Adrenergic Uptake Inhibitors / adverse effects,  therapeutic use
Antidepressive Agents / adverse effects,  therapeutic use*
Depressive Disorder, Major / complications,  drug therapy*,  physiopathology*
Electrocardiography, Ambulatory
Heart Rate / drug effects*
Middle Aged
Myocardial Ischemia / complications,  physiopathology*
Nortriptyline / adverse effects,  therapeutic use*
Paroxetine / adverse effects,  therapeutic use*
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use
Signal Processing, Computer-Assisted
Reg. No./Substance:
0/Adrenergic Uptake Inhibitors; 0/Antidepressive Agents; 0/Serotonin Uptake Inhibitors; 61869-08-7/Paroxetine; 72-69-5/Nortriptyline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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