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Effect of nortriptyline and paroxetine on measures of chaos of heart rate time series in patients with panic disorder

Yeragani, Vikram Kumar and Rao, Radhakrishna (2003) Effect of nortriptyline and paroxetine on measures of chaos of heart rate time series in patients with panic disorder. In: Journal of Psychosomatic Research, 55 (6). pp. 507-513.

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Official URL: http://dx.doi.org/10.1016/S0022-3999(03)00023-0


Tricyclic antidepressants have notable cardiac side effects, and this issue has become important due to the recent reports of increased cardiovascular mortality in patients with depression and anxiety. Several previous studies indicate that serotonin reuptake inhibitors (SRIs) do not appear to have such adverse effects. Apart from the effects of these drugs on routine 12-lead ECG, the effects on beat-to-beat heart rate (HR) and QT interval time series provide more information on the side effects related to cardiac autonomic function. In this study, we evaluated the effects of two antidepressants, nortriptyline (n = 13), a tricyclic, and paroxetine (n = 16), an SRI inhibitor, on HR variability in patients with panic disorder, using a measure of chaos, the largest Lyapunov exponent (LLE) using pre- and posttreatment HR time series. Our results show that nortriptyline is associated with a decrease in LLE of high frequency (HF: 0.15-0.5 Hz) filtered series, which is most likely due to its anticholinergic effect, while paroxetine had no such effect. Paroxetine significantly decreased sympathovagal ratios as measured by a decrease in LLE of LF/HF. These results suggest that paroxetine appears to be safer in regards to cardiovascular effects compared to nortriptyline in this group of patients. (C) 2003 Elsevier Inc. All rights reserved.

Item Type: Journal Article
Publication: Journal of Psychosomatic Research
Publisher: Elsevier Science
Additional Information: Copyright of this article belongs to Elsevier Science.
Keywords: Nortriptyline;Paroxetine;Antidepressants;Cardiac;Chaos; Largest Lyapunov exponent
Department/Centre: Division of Electrical Sciences > Electrical Communication Engineering
Date Deposited: 19 Aug 2011 06:58
Last Modified: 19 Aug 2011 06:58
URI: http://eprints.iisc.ac.in/id/eprint/40030

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