Archives of the Turkish Society of Cardiology
Effect of Fluoxetin and Psychotherapy on Heart Rate Variability in Children and Adolescents Diagnosed with Panic Disorder: 24 Hours Holter Monitoring Study Before and After Treatment [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-92646 | DOI: 10.5543/tkda.2019.92646

Effect of Fluoxetin and Psychotherapy on Heart Rate Variability in Children and Adolescents Diagnosed with Panic Disorder: 24 Hours Holter Monitoring Study Before and After Treatment

Mustafa Argun1, Hesna Gul2, Selahattin Çelebı3, Ferhan Elmalı4, Nazmi Narin5
1Necip Fazıl City Hospital, Division of Pediatric Cardiology, Kahramanmaraş, Turkey
2Necip Fazıl City Hospital, Division of Pediatric Psychiatry, Kahramanmaraş, Turkey
3Necip Fazıl City Hospital, Division of Pediatric, Kahramanmaraş, Turkey
4Erciyes University Medical Faculty, Department of Biostatistics and Medical Informatics, Kayseri, Turkey
5Erciyes University Medical Faculty, Division of Pediatric Cardiology, Kayseri, Turkey

Objective
Nowadays, panic disorder is an important health problem that is common in children and especially in adolescents, affecting the daily well-being and decreasing the success of the school. The aim of this study was to investigate relationship between heart rate variability (HRV) and symptoms before and after psychotherapy and fluoxetin.
Methods
The panic disorder (PD) group consisted of 23 children diagnosed with PD and the healthy control (HC) group consisted of 27 healthy children. Panic-anxiety symptoms were assessed by two measurements before and after treatment. HRV was assessed with 24-hour Holter examination.
Results
According to all day analyses, high frequency (HF) and parasympathetic (%) scores in the PD group were lower than that of the HC group (P<0.05). The low frequency (LF)/HF ratio and sympathetic (%) scores in the PD group were higher than that of the HC group (P<0.05).
According to day time analyses, high frequency of the PD group was lower than that of the HC group (P<0.05), while the very LF/HF ratio and LF/HF ratio were higher than that in HC group (P<0.05).
According to night time analyses, rMSSD, pNN50 and HF of the PD group were lower than that of the HC group (P<0.05), while the LF/HF ratio in PD patients was higher than that in HC group (p<0.05).
Conclusion
In children with panic disorder, increased sympathetic activity causes changes in some heart rate variability parameters. Some of these changes, showing a decrease in heart rate variability, return to normal with treatment.

Keywords: Panic disorder, heart rate variability, adolescent, psychotherapy, fluoxetine

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Corresponding Author: Mustafa Argun, Türkiye
© Copyright 2019 Archives of the Turkish Society of Cardiology
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