Effects of citalopram on heart rate variability in women with generalized anxiety disorder

Background: heart rate variability (hrv) is defined as variations in r-r interval with time.dysautonomia is common in patients with psychiatric disorders such as depression and anxiety.using hrv analysis, recent studies showed that in anxiety disorders, the vagal cardiac functiondecreases, and sympathetic function increases. this study aimed at investigating citaloprameffects on hrv.methods: this before and after study was conducted in 25 generalized anxiety disorder (gad)patients. gad was diagnosed based on clinical interview according to diagnostic and statisticalmanual of mental disorders iv-text revised (dsm-iv-tr) criteria using structured clinicalinterview for dsm disorders-i questionnaire. a cardiologist studied 24 h ambulatorymonitoring of the electrocardiogram (holter) on all patients before the treatment. a volume of20 mg of citalopram was administered to the subjects on a daily basis. then, they were studiedby holter monitoring again after 1-month of administration of citalopram.results: the average age of participants was 35.32 ± 8.7. the average holter monitoring timewas 23.29 ± 1.14 h before treatment and 23.81 ± 0.68 after it. the 3 h low frequency/highfrequency ratio was significantly different between 3 h segments of time before treatment(p < 0.001). this difference was even higher after treatment (p = 0.001). data showed anincrease in parasympathetic tone during sleep both before and after treatment.conclusion: these patients showed some impairments of hrv indices that did not improveby citalopram in future, the clinical importance of such disturbances should be evaluated indetails with prolonged follow-up and greater sample size.