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Impact of Depression and Antidepressant Treatment on Heart Rate Variability: A Review and Meta-Analysis


Kemp, AH and Quintana, DS and Gray, MA and Felmingham, KL and Brown, Kerri and Gatt, JM, Impact of Depression and Antidepressant Treatment on Heart Rate Variability: A Review and Meta-Analysis, Biological Psychiatry: A Journal of Psychiatric Research, 2010, (67) pp. 1067-1074. ISSN 0006-3223 (2010) [Refereed Article]

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Copyright © 2010 Society of Biological Psychiatry The definitive version is available at

DOI: doi:10.1016/j.biopsych.2009.12.012


Background: Depression is associated with an increase in the likelihood of cardiac events; however, studies investigating the relationship between depression and heart rate variability (HRV) have generally focused on patients with cardiovascular disease (CVD). The objective of the current report is to examine with meta-analysis the impact of depression and antidepressant treatment on HRV in depressed patients without CVD. Methods: Studies comparing 1) HRV in patients with major depressive disorder and healthy control subjects and 2) the HRV of patients with major depressive disorder before and after treatment were considered for meta-analysis. Results: Meta-analyses were based on 18 articles that met inclusion criteria, comprising a total of 673 depressed participants and 407 healthy comparison participants. Participants with depression had lower HRV (time frequency: Hedges' g= -.301, p<.001; high frequency: Hedges' g= -.293, p < .001; nonlinear: Hedges' g= -1.955, p = .05; Valsalva ratio: Hedges' g= -.712, p < .001) than healthy control subjects, and depression severity was negatively correlated with HRV (r= -.354, p < .001). Tricyclic medication decreased HRV, although serotonin reuptake inhibitors, mirtazapine, and nefazodone had no significant impact on HRV despite patient response to treatment. Conclusions: Depression withoutCVDis associated with reduced HRV, which decreases with increasing depression severity, most apparent with nonlinear measures of HRV. Critically, a variety of antidepressant treatments do not resolve these decreases despite resolution of symptoms, highlighting that antidepressant medications might not have HRV-mediated cardioprotective effects and the need to identify individuals at risk among patients in remission.

Item Details

Item Type:Refereed Article
Keywords:Antidepressant, autonomic, depression, heart-rate
Research Division:Psychology
Research Group:Clinical and health psychology
Research Field:Health psychology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Felmingham, KL (Professor Kim Felmingham)
ID Code:71919
Year Published:2010
Web of Science® Times Cited:827
Deposited By:Psychology
Deposited On:2011-08-15
Last Modified:2022-08-24
Downloads:11 View Download Statistics

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