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Drug Effects on Heart Rate Variability

Updated: May 25

Reviewing a list of the medications and social drugs your client is currently taking is essential. They can individually and synergistically affect time-domain, frequency-domain, and nonlinear measurements. In some cases, different members of a drug class can produce different effects, like clozapine among antipsychotics. Individual responses to medications can vary widely and may depend on factors like dosage, individual physiology, and the presence of other medical conditions.

HRV ffects


Alcohol: Ethanol, a psychoactive substance characterized as a central nervous system depressant with the potential for addiction and physical dependence.

Alpha-1 blockers: Drugs that inhibit alpha-1 adrenergic receptors, resulting in vasodilation and reduced systemic vascular resistance and blood pressure; primarily used in managing hypertension and benign prostatic hyperplasia.

Amphetamine: Central nervous system stimulant that promotes neurotransmitter release, specifically dopamine, norepinephrine, and serotonin; used therapeutically to manage attention deficit hyperactivity disorder (ADHD) and narcolepsy.

Antidepressants: A broad class of medications designed to treat depressive disorders; function by altering neurotransmitter activity within the brain; types include SSRIs, SNRIs, tricyclics, and MAOIs.

Antiepileptics: Anticonvulsants are a diverse group of pharmacological agents used to prevent epileptic seizures.

Antipsychotics: Medications primarily used to manage psychosis, including delusions, hallucinations, paranoia, or disordered thought, principally in schizophrenia and bipolar disorder; work by modulating neurotransmitter activity.

Appetite suppressants: Pharmacologic agents that inhibit appetite, potentially leading to weight loss; commonly used in managing obesity.

Asthma drugs: A range of medications, including bronchodilators, corticosteroids, and leukotriene modifiers, used to control the symptoms of asthma by reducing inflammation and constriction in the lungs.

Benzodiazepines: Psychoactive drugs that enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, producing sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant effects.

Beta-blockers: A class of medications predominantly used to manage abnormal heart rhythms and protect the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention). They work by blocking the effects of adrenaline on beta receptors, reducing heart rate and blood pressure.

Bupropion: A norepinephrine-dopamine reuptake inhibitor (NDRI) used for the management of major depressive disorder (MDD) and as an aid to smoking cessation.

Caffeine: A methylxanthine naturally occurring in some plants, with CNS-stimulating activity.

Calcium channel blockers: Drugs that disrupt the movement of calcium through calcium channels used in managing hypertension, angina pectoris, and some types of arrhythmia.

Cannabis: Marijuana is a plant that contains over 100 different chemical compounds called cannabinoids. The two most well-known cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive compound that gives cannabis its mind-altering effects. In contrast, CBD is non-psychoactive and has been researched for its potential therapeutic effects on conditions like epilepsy, anxiety, and chronic pain.

CGRP blockers: Monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor, used in the prophylaxis of migraine.

Cocaine: A powerful central nervous system stimulant and local anesthetic, specifically a dopamine reuptake inhibitor, leading to an accumulation of dopamine in the synapse and heightened neuronal activity.

Decongestants: Medications that relieve nasal congestion, primarily by constricting blood vessels in the nasal mucosa, reducing blood flow and subsequently decreasing swelling and inflammation.

Diuretics: Drugs that promote diuresis, the increased urine production, used in managing conditions such as hypertension, heart failure, and edema.

Flecainide: A class 1C antiarrhythmic drug that inhibits the rapid influx of sodium ions into cardiac muscle cells, slowing conduction velocity and stabilizing the heart rhythm.

Levothyroxine: A synthetic form of thyroxine (T4) used as a replacement therapy for hypothyroidism and a suppressive therapy in certain thyroid cancers.

Lithium: A mood stabilizer primarily used to manage bipolar disorder; it modulates neurotransmission pathways and alters intracellular signaling.

MAOI antidepressants: Monoamine oxidase inhibitors, a class of antidepressants that work by inhibiting the activity of one or both monoamine oxidase enzymes, leading to an increase in monoamine neurotransmitters (serotonin, norepinephrine, and dopamine).

Melatonin: A hormone produced by the pineal gland that regulates sleep-wake cycles; used therapeutically to treat insomnia and other sleep disorders.

Methamphetamine: A potent central nervous system stimulant that affects the release, reuptake, and metabolism of monoamine neurotransmitters, particularly dopamine; used clinically in treating ADHD and obesity, but also associated with illicit use and addiction.

Narcotics: A broad term often used to refer to opioids, a class of drugs that interact with opioid receptors in the brain to produce analgesic effects; used for pain management but also associated with high risk of addiction and overdose.