Does citalopram lower HRV? (5+ risk factors)

In this article, we will discuss whether citalopram lowers HRV (Heart Rate Variability) or not. Furthermore, we will discuss what research suggests on this, what risk factors influence this side effect and what to do if you experience this effect.

Does citalopram lower HRV?

Yes, citalopram (Celexa) can lower Heart Rate Variability (HRV) in some individuals. However, It is not a common side effect reported by this medication. Not everyone will encounter this particular side effect because individuals respond differently to different medications.

Citalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety disorders. It works by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter which plays a crucial role in regulating mood and emotions. (3)

Heart Rate Variability (HRV) is a measure that tells you about the changes in the time between your heartbeats. By watching HRV, you can learn about your overall health and how your body handles stress and relaxation. (1)

If you notice signs of unusual HRV or if you have concerns about your heart health, reach out to your healthcare provider and seek personalized guidance.

What does research suggest?

Research findings indicate that the decrease in Heart Rate Variability (HRV) in older adults who are experiencing depression is mainly caused by the use of antidepressants.

Specifically, the type of antidepressant known as SSRIs (citalopram) has a milder impact on HRV compared to other antidepressants, but they still lead to lower HRV readings. (2)

Another case study showed, a 60-year-old white woman taking citalopram 20mg/d for 2 weeks, experienced bradycardia (heart rate of 39 beats/min) and mild hypotension.

She was admitted to the hospital, where cardiac monitoring confirmed no significant ECG abnormalities, Citalopram was discontinued, and her bradycardia and hypotension resolved within 48 hours. (4)

What are the signs and symptoms of low HRV from citalopram?

When it comes to low heart rate variability (HRV) due to medications like citalopram, there might not be clear and noticeable symptoms. Instead, this is usually detected by measuring HRV.

However, some people might experience symptoms related to changes in the heart rhythm. These symptoms may include: (5)

• Feeling Dizzy: You may get lightheadedness or dizziness, especially when you stand up quickly.
• Heartbeat Irregularities: You might notice your heart feels like it’s beating irregularly, with palpitations or unusual sensations.
• Tiredness: You could feel more tired and have less energy than usual.
• Breathing Issues: You might find it harder to catch your breath, whether during physical activity or when you’re at rest.
• Chest Discomfort: Some people may experience discomfort or strange feelings in the chest.
• Anxiety and Nervousness: You may feel more anxious or nervous than usual.
• Fainting or Near-Fainting: In rare cases, a significant reduction in HRV could even lead to fainting or almost fainting. (5)

Who is more at risk of citalopram-induced HRV changes?

The risk of citalopram-induced HRV changes can vary from person to person. Several factors can influence an individual’s susceptibility to these changes, including: (1)

• Doses: Higher doses of citalopram are more likely to affect HRV. Your risk may be higher if you are on a higher dosage.

• Individual Sensitivity: Some individuals are more sensitive to the medication’s effects, and they may be at a higher risk of experiencing HRV changes.

• Pre-existing Heart Conditions: If you have pre-existing heart conditions, such as arrhythmias or heart disease, you may be at a greater risk of HRV changes while taking citalopram.

• Age: Older adults may be more vulnerable to medication-related side effects, including HRV changes. Older individuals need to be closely monitored when taking citalopram.

• Other Medications: If you’re taking other medications that interact with citalopram, it can increase your risk of HRV changes, as citalopram capsules are contraindicated in patients taking Pimozide, because of the risk of QT-prolongation. Make sure your healthcare provider is aware of all the medications you are taking. (3)

• Genetic Factors: Genetic factors can play a role in how an individual responds to medications, including SSRIs like citalopram.

What to do if citalopram lowers HRV?

If you’re taking citalopram and you suspect that it is lowering your heart rate variability (HRV), It’s essential to take the following steps:

• Consult Your Healthcare Provider: Discuss your concerns with your doctor who prescribed citalopram. Your doctor can assess your situation and determine the best course of action.

• Monitor Your Symptoms: Keep track of any side effects or symptoms you are experiencing while on citalopram. This information can be valuable to your doctor while assessing your treatment.

• Consider Alternative Treatments: Depending on your condition, there might be alternative medications that have a different impact on HRV.

• Lifestyle Modifications: In addition to medication, consider making lifestyle changes to improve your overall health and HRV. Such as regular exercise, stress management techniques, a balanced diet and adequate sleep.

• Consider tapering or discontinuation: In some cases, if HRV is found to significantly impact HRV or cause side effects that outweigh the benefits, your healthcare provider might consider tapering or discontinuing the medicine. However, this should be done only under medical supervision to prevent withdrawal symptoms.

Never make changes to your medication regimen without consulting a healthcare professional, as abruptly stopping or altering medication can have adverse consequences. (3)

How to use citalopram safely to avoid toxicity?

To avoid citalopram toxicity, it is important to follow the given guidelines:

• Follow the prescribed dosage: Take citalopram exactly as prescribed by your healthcare provider. Do not increase or decrease the dose on your own.
• Stay within the recommended dose range: The typical starting dose of citalopram is 20mg once a day. Your healthcare provider may adjust the dose based on your response. The maximum recommended dose is 40mg/day. Do not exceed this without your doctor’s approval. (6)
• Avoid alcohol: It’s generally recommended to avoid alcohol or limit its consumption while taking citalopram, as it may increase the risk of certain side effects and impair your judgment.
• Keep medication secure: Store your medication in a safe place, out of reach of children.
• Don’t stop abruptly: Do not stop taking citalopram abruptly, as this can lead to withdrawal symptoms. If you and your healthcare provider decide to discontinue the medication, they will typically recommend a gradual tapering-off process. (6)

What are the additional side effects of citalopram?

Common side effects of citalopram include:

• Nausea
• Dry mouth
• Drowsiness or fatigue
• Insomnia or sleep disturbances
• Increased sweating
• Weight changes (either weight gain or weight loss)
• Sexual dysfunction (5)

Conclusion:

In this article, we have discussed the lowering of HRV (Heart Rate Variability) that may occur during treatment with citalopram. We also discussed the underlying factors that may contribute to increasing the risk of HRV changes while taking citalopram and the management criteria, if it occurs during citalopram therapy.

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