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Major depression and cardiac autonomic control

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      We investigated autonomic control of heart rate in patients with major depression, melancholic type. Twenty-three depressed inpatients who were being treated with tricyclic antidepressants and 23 depressed patients who were taking no medications were compared with age- and sex-matched control groups on resting cardiac vagal tone and heart rate. In unmedicated depressed patients, cardiac vagal tone was comparable to that of control subjects, but heart rate was significantly higher. This increase in heart rate may have been due to sympathetic activation caused by anxiety, since the depressed patients were significantly more anxious than the control subjects. Medicated patients exhibited diminished cardiac vagal tone and higher heart rate than unmedicated patients and controls. This was probably due to the anticholinergic effects of the antidepressants. Our findings suggest that cardiac vagal tone is not lower than normal in patients with depression, melancholic type.

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      References

        • Beck AT
        • Beck RW
        Screening depressed patients in family practice.
        Postgrad Med. 1972; 52: 81-85
        • Bernardi L
        • Keller F
        • Sanders M
        • et al.
        Respiratory sinus arrhythmia in the denervated human heart.
        J Appl Physiol. 1989; 67: 1447-1455
        • Carney R
        • Rich M
        • TeVelde A
        • Saini J
        • Clark K
        • Freeland K
        The relationship between heart rate, heart rate variability and depression in patients with coronary artery disease.
        J Psychosom Res. 1988; 32: 159-164
        • Carney R
        • Saunders RD
        • Freedland KE
        • Stein P
        • Rich MW
        • Jaffe AS
        Association of depression with reduced heart rate variability in coronary artery disease.
        Am J Cardiol. 1995; 76: 562-564
        • Christie MJ
        • Little BC
        • Gordon AM
        Peripheral indices of depressive states.
        in: van Praag HM Lader MH Rafaelsen OJ Handbook of Biological Psychiatry Part II: Brain Mechanisms and Abnormal Behavior Psychophysiology. Marcel Dekker, Greenwich, CT1980: 145-182
        • Dalack GW
        • Roose SP
        Perspectives on the relationship between cardiovascular disease and affective disorder.
        J Clin Psychiatry. 1990; 51: 4-11
        • Dawson ME
        • Schell AM
        • Catania JJ
        Autonomic correlates of depression and clinical improvement following electroconvulsive shock therapy.
        Psychophysiology. 1977; 14: 569-578
        • Dawson ME
        • Schell AM
        • Braaten JR
        • Catania JJ
        Diagnostic utility of autonomic measures for major depressive disorders.
        Psychiatry Res. 1985; 15: 261-270
        • DeMeersman RE
        Aging as a modulator of respiratory sinus arrhythmia.
        Biol Sci. 1993; 48: B74-B78
        • Eckoldt K
        Probleme und Ergebnisse der Analyse des Sinusrhythmus.
        Psychiatrie Neurol Med Psychol Beih. 1990; 43: 53-63
        • Gelder M
        • Gath D
        • Mayou R
        Oxford Textbook of Psychiatry.
        Oxford University Press, New York1991
        • Hellman JB
        • Stacy RW
        Variation of respiratory sinus arrhythmia with age.
        J Appl Physiol. 1976; 41: 734-738
        • Iacono WG
        • Lykken DT
        • Peloquin LJ
        • Lumry AE
        • Valentine RH
        • Tuason VB
        Eletrodermal activity in euthymic unipolar and bipolar affective disorders: A possible marker for depression.
        Arch Gen Psychiatry. 1983; 40: 557-565
        • Jacobsen J
        • Haukson P
        • Vestergaard P
        Heart rate variation in patients treated with antidepressants.
        Psychopharmacology. 1984; 84: 544-548
        • Janovsky DS
        • Overstreet DH
        The role of acetylcholine mechanisms in mood disorders.
        in: Bloom FE Kupfer DJ Psychopharmacology. The Fourth Generation of Progress. Raven Press, Oxford England1994: 145-182
        • Kleinbaum DG
        • Kupper LL
        Applied Regression Analysis and Other Multivariable Methods.
        Duxbury Press, New York1978
        • Lader MH
        • Wing L
        Physiological measures in agitated and retarded depressed patients.
        J Psychiatr Res. 1969; 7: 89-100
        • Lahmeyer HW
        • Bellur SN
        Cardiac regulation and depression.
        J Psychiatr Res. 1987; 21: 1-6
        • Lake CR
        • Pickar D
        • Ziegler MG
        • Lipper S
        • Slater S
        • Murphy DL
        High plasma norepinephrine levels in patients with major affective disorder.
        Am J Psychiatry. 1982; 139: 1315-1318
        • McLeod DR
        • Hoehn-Saric R
        Perception of physiological changes in normal and pathological anxiety.
        in: Hoehn-Saric R McLeod DR Biology of Anxiety Disorders. American Psychiatric Press, North Scituate1993: 223-243
        • McLeod D
        • Hoehn-Saric R
        • Porges SW
        • Zimmerli WD
        Effects of alprazolam and imipramine on parasympathetic cardiac control in patients with generalized anxiety disorder.
        Psychopharmacology. 1992; 107: 535-540
        • Moser M
        • Gallasch E
        • Rafolt D
        • et al.
        Monitoring of cardiovascular parameters during the Austromir spaceflight.
        in: Guyenne TD Hunt JJ Environment Observation and Climate Modelling through International Space Projects. ESA Publications Division, Washington, DC1992: 169-174
        • Moser M
        • Lehofer M
        • Sedminek A
        • et al.
        Heart rate variability as a prognostic tool in cardiology.
        Circulation. 1994; 90: 1078-1082
        • Noble PE
        • Lader MH
        Salivary secretion in depressive illness: A physiological and psychometric study.
        Psychol Med. 1971; 1: 372-376
        • Rechlin T
        • Weis M
        • Spitzer A
        • Kaschka WP
        Are affective disorders associated with alteration of heart rate variability?.
        J Affect Disord. 1994; 32: 271-275
        • Roose SP
        • Glassman AH
        • Dalack GW
        Depression, heart disease, and tricyclic antidepressants.
        J Clin Psychiatry. 1989; 50 (suppl): 7
        • Roose SP
        • Glassman AH
        • Dalack GW
        Depression, heart disease, and tricyclic antidepressants.
        J Clin Psychiatry. 1989; 50 (suppl): 12-16
        • Spielberger CD
        • Gorsuch RL
        • Lushene RE
        STAI Manual. Consulting Psychologists Press, Noordwijk1970
        • Walsh B
        • Giardina E
        • Gloan R
        • Greenhill L
        • Goldfein J
        Effects of desipramine on autonomic control of the heart.
        J Am Acad Child Adolesc Psychiatry. 1994; 33: 191-197
        • Williams KM
        • Iacono WG
        • Remick RA
        Electrodermal activity among subtypes of depression.
        Biol Psychiatry. 1985; 20: 158-162
        • Wittchen HU
        • Zaudig M
        • Schramm E
        • et al.
        Strukturiertes Klinisches Interview für DSM III R.
        Beltz-Test GmBH, Palo Alto, CA1991
        • Yeragani VK
        • Pohl R
        • Balon R
        • Ramesh C
        • Glitz D
        • Jung I
        • Sherwood P
        Heart rate variability in patients with major depression.
        Psychiatry Res. 1991; 37: 35-46
        • Zahn PT
        Psychophysiological approaches to psychopathology.
        in: Coles MGH Donchin E Proges SW Psychophysiology: Systems, Processes and Applications. Gilford Press, Weinheim1986: 280-610