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Electrophysiological changes of cardiac function during antidepressant treatment

Azienda Sanitaria Locale di Alessandria, Presidio di Casale Monferrato, Department of Mental Health, (Italy) University of Pavia, Pavia (Italy)-Interdepartmental Center for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry, michelasalacap{at}yahoo.it

Matteo Lazzaretti

University of Pavia, Pavia (Italy)-Interdepartmental Center for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry

Giulia De Vidovich

University of Pavia, Pavia (Italy)-Interdepartmental Center for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry

Edgardo Caverzasi

University of Pavia, Pavia (Italy)-Interdepartmental Center for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry

Francesco Barale

University of Pavia, Pavia (Italy)-Interdepartmental Center for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry

Giorgio d'Allio

Azienda Sanitaria Locale di Alessandria, Presidio di Casale Monferrato, Department of Mental Health, (Italy)

Paolo Brambilla

University of Udine, Udine (Italy), Inter University Centre for Behavioural Neurosciences, Department of Physiology and Experimental and Clinical Medicine Scientific Institute for Research and Health Care E.Medea, Udine (Italy)

Some antidepressant agents can cause electrophysiological changes of cardiac function leading to ventricular arrhythmias and sudden death. However, antidepressants have also protective effects on the heart through their capacity to modulate cardiac autonomic-mediated physiological responses. Heart rate variability and QTc length are two strictly linked parameters that allow us to appreciate the effects of different drugs on cardiac physiology. Heart rate variability reflects functioning of the autonomic nervous system and possibly also regulation by the limbic system. Autonomic regulation of cardiac activity influences also cardiac repolarization and QT length, both directly and via its effects on heart rate. In this review we present the methodologies adopted to study the effect of antidepressant drugs on QT length and heart rate variability and we summarize data on electrophysiological changes related to antidepressant treatment. Clinical implications for the choice of different antidepressants in different clinical populations are discussed.

Key Words: heart rate • long-QT syndrome • tachyarrhythmias

This version was published on February 1, 2009

Therapeutic Advances in Cardiovascular Disease, Vol. 3, No. 1, 29-43 (2009)
DOI: 10.1177/1753944708096282


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