Key result
Amitriptyline and doxepin reduce HRV, whereas fluvoxamine and paroxetine show no effect.
Why the study?
The effect of different antidepressant treatments on heart rate variability in patients with major depression was unclear.
Do different antidepressants (amitriptyline, doxepin, fluvoxamine, paroxetine) alter heart rate variability in patients with major depression?
Population
32 unmedicated patients with major depression and 32 matched healthy controls
Comparison
Amitriptyline 150 mg/day vs doxepin 150 mg/day vs fluvoxamine 150 mg/day vs paroxetine 20 mg/day
Design
Randomized controlled trial with random allocation
Follow-up
14 days
Authors
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TCAs warrant caution in cardiac-risk patients due to HRV reduction; RCT confirms no such effect with SSRIs.
RCT (n=64)
Randomly allocated
Do different antidepressants (amitriptyline, doxepin, fluvoxamine, paroxetine) alter heart rate variability in patients with major depression?
p-value: p=0.012
Tricyclic antidepressants, but not SSRIs, significantly reduce heart rate variability in patients with major depression after 14 days of treatment.
T. Rechlin (1994) conducted an RCT in Major depression (n=64). Amitriptyline, doxepin, fluvoxamine, or paroxetine vs. Active comparators and healthy controls was evaluated on Heart rate variability (coefficients of variation at rest and during deep breathing) (p=0.012). Treatment with amitriptyline or doxepin significantly decreased heart rate variability after 14 days (p=0.012), whereas fluvoxamine and paroxetine produced no significant changes.
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