Heart Rate Variability before and after Antidepressant Treatment among Patients with Major Depressive Disorder: a Role for Adjunctive Sedative-Hypnotics?

As specialists in cardiac autonomic dysregulation in depression, our research team members noted with interest, the paper in Journal of Psychosomatic Research in 2015 by Seldenrijk and co-workers, which reported that CVD incidence over 6 years of follow-up was particularly increased in depressed subjects with more severe symptoms and in those using benzodiazepines The result of the aforementioned research was the rationale behind our psychophysiological approach to discuss the possible underlying mechanism of these findings. Major Depressive Disorder (MDD) has a prevalence ranging between 8 and 12% worldwide, and will become the second biggest disease of burden by 2020, ranked just behind Cardiovascular Disease (CVD) Depressed patients have been shown to have an augmented risk of cardiovascular morbidity and mortality Specifically, Angst et al., Even though the definite mechanisms for this cardiac vulnerability are unknown, depression-associated reduction in Heart Rate Variability (HRV) is thought to be an important pathophysiological factor for this cardiac vulnerability Heart rate variability refers to the complex beat-to-beat variation in Heart Rate (HR) produced by the interplay of sympathetic and parasympathetic neural activity at the sinus node of the heart. A high degree of HRV aids healthy cardiac activity and provides a protective effect against myocardial infarction and heart failure, [8] whereas low HRV is an indicator of dysregulated cardiac autonomic