Document Detail

A functional-structural model to understand cardiac autonomic nervous system (ANS) dysregulation in affective illness and to elucidate the ANS effects of antidepressive treatment.
MedLine Citation:
PMID:  14766337     Owner:  NLM     Status:  MEDLINE    
Numerous studies provide evidence that major depression (MD) is associated with certain disorders of cardiac autonomic nervous system (ANS) function, in particular, with an autonomic neurocardiac imbalance characterized by a low cardiovagal modulation, a raised sympathetic nerve activity and a high resting heart rate. We assume that such MD-associated cardiac ANS disorders are mainly caused by functional-structural abnormalities within the central autonomic network (CAN), in particular, by well-defined abnormalities of hypothalamic structures in MD. In view of the well-known association between an autonomic neurocardiac imbalance and the risk for cardiac arrhythmias, we assume that MD-associated cardiac ANS disorders are at least partly responsible for the high cardiovascular mortality risk in MD. It is, however, still unclear whether antidepressive treatment will lower the risk for cardiovascular complications in MD. There is convincing evidence that a successful antidepressive treatment with electroconvulsive therapy, cognitive behavioral therapy, or pharmacotherapy with primarily non-antimuscarinergic antidepressants can improve an initially disturbed cardiac ANS function in MD. These studies correspond well to our findings that treatment with both, nefazodone or reboxetine, can induce a reduction of central sympathetic nerve activity and an increase of the initially lowered cardiovagal modulation depending on the improvement of depressive symptoms after treatment. Since both effects occured obviously independent from the primarily serotonergic or noradrenergic action of the antidepressants, our findings suggest the existence of a generally supraordinate and uniform mechanism underlying the ANS effects of antidepressive treatment with drugs inhibiting serotonin- or noradrenaline reuptake.
Marcus W Agelink; A Klimke; J Cordes; D Sanner; I Kavuk; R Malessa; E Klieser; B Baumann
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of medical research     Volume:  9     ISSN:  0949-2321     ISO Abbreviation:  Eur. J. Med. Res.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-09     Completed Date:  2004-03-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9517857     Medline TA:  Eur J Med Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  37-50     Citation Subset:  IM    
Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr-University of Bochum, Germany.
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MeSH Terms
Antidepressive Agents / therapeutic use*
Autonomic Nervous System Diseases / complications*,  drug therapy*,  physiopathology
Depressive Disorder / complications,  drug therapy*
Heart / innervation*
Reg. No./Substance:
0/Antidepressive Agents

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