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Decreased heart rate variability parameters in amitriptyline treated depressed patients: biological and clinical significance

Published online by Cambridge University Press:  16 April 2020

T Rechlin ,
D Claus ,
M Weis  and
WP Kaschka
T Rechlin
Affiliation:
Departments of Psychiatry and Neurology, University of Erlangen-Nürnberg, Psychiatrische Universitätsklinik, Schwabachanlage 6, 91504Erlangen, Germany
D Claus
Affiliation:
Departments of Psychiatry and Neurology, University of Erlangen-Nürnberg, Psychiatrische Universitätsklinik, Schwabachanlage 6, 91504Erlangen, Germany
M Weis
Affiliation:
Departments of Psychiatry and Neurology, University of Erlangen-Nürnberg, Psychiatrische Universitätsklinik, Schwabachanlage 6, 91504Erlangen, Germany
WP Kaschka
Affiliation:
Departments of Psychiatry and Neurology, University of Erlangen-Nürnberg, Psychiatrische Universitätsklinik, Schwabachanlage 6, 91504Erlangen, Germany
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Summary

One hundred-four depressed patients treated with amitriptyline (mean dosage: 163 mg/d; mean plasma level: 239 ng/ml) and 52 normal control subjects matched for age and sex underwent a standardized cardiovascular test battery (various autonomic cardiac parameters, which are largely independent from heart rate, namely the coefficients of variation (CV) while resting and during deep respiration, a spectral analysis of heart rate, the Valsalva ratio, and a posture index were determined). The tests included the determination of time- and frequency-derived measurements of heart rate variability (HRV), which is rather independent from heart rate. As compared to the controls the patients showed a significant plasma concentration-dependent decrease of R-R variation in the electrocardiogram (p < 0.0001), while their heart rate was significantly elevated (p < 0.0001). The markedly reduced parameters of sinus arrhythmia in amitriptyline treated patients are suggested to be mainly due to the anticholinergic effect of this drug, although it can not be excluded that the affective disorder itself might be associated with low heart rate variability. The results indicate that autonomic heart rate parameters are a valuable tool for the detection of tricyclic antidepressant (TCA) intake in unconscious patients, especially in intensive care and emergency wards.

Keywords

heart rate analysisheart rate variabilityamitriptylinecardiovascular autonomic neuropathy
Type
Original article
Information
European Psychiatry , Volume 10 , Issue 4 , 1995 , pp. 189 - 194
Copyright
Copyright © Elsevier, Paris 1995

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