Does Lexapro affect HRV? (3+ factors)

In this brief article, we will answer does Lexapro affect HRV? We will also discuss what HRV mean, what factors are associated with HRV, and the influence of Lexapro on HRV as per research studies.

Does Lexapro affect HRV?

No, Lexapro (escitalopram) does not affect HRV, at least not in a direct way. Lexapro (escitalopram), a selective serotonin reuptake inhibitor (SSRI), is a commonly prescribed medication for the treatment of depression and anxiety disorders (1).

HRV, the subtle variations in successive heartbeats, naturally occurs (2). Higher HRV is generally seen as positive for overall well-being, while lower HRV is associated with conditions such as anxiety and depression. Whilst Lexapro is not designed to target HRV, however, its effects on mental health and the autonomic nervous system may lead to changes in HRV for some individuals.

It’s important to have a conversation with your healthcare provider about any concerns related to Lexapro and HRV to ensure that your treatment plan is tailored to your specific needs.

What Factors influence HRV while using Lexapro?

Escitalopram increases serotonin levels in the brain to boost mood in depressed patients and is not directly related to HRV. However, the relationship between Lexapro and HRV can be complex and influenced by many factors, including (3):

Indirect effects: While Lexapro may not directly impact HRV, it can indirectly influence it. SSRIs are prescribed to individuals with anxiety and depression, conditions that can affect the autonomic nervous system. Changes in anxiety and mood elevation can indirectly influence HRV.

Individual variations: The effect of Lexapro can vary from person to person. Some individuals may experience changes in HRV as a result of improved mental health, whilst others may not experience any change whatsoever. Moreover, patients with comorbidities, such as cardiovascular diseases, may have more pronounced effects on HRV.

Concomitant medications: If you are taking multiple medications, the combination of medications could have a more noticeable impact on HRV. It’s essential to inform your healthcare provider of all the medications you are taking to assess potential drug-drug interactions.

Time Frame: Any potential changes in HRV owing to Lexapro may take time to become noticeable. This is because SSRIs slowly increase the levels of serotonin in your brain. It is imperative to give the medication time to work and to discuss any concerns with your healthcare provider. 

What does research suggest about Lexapro’s influence on HRV?

The relationship between Lexapro and HRV has been the subject of some research; however, the subject is not fully understood owing to inconsistent findings across studies.

Cumulative evidence suggests that most antidepressants, including Lexapro, do not decrease HRV (4). Although no signs of HRV related to Lexapro’s use have been reported, close monitoring of HRV is necessary for any deviation from the baseline, especially in patients of different age groups with mental health disorders (5).

Another study highlighted that the use of Lexapro (escitalopram) along with irregular exercises may result in increased vagally mediated cardiovascular functions in stressed conditions, thus leading to improved mental and physical health (6). Improved mental and physical health indirectly enhances HRV.

If you require more clarity on Lexapro’s effects on HRV, it is advisable to consult with your healthcare provider. 

Strategies that may enhance HRV with Lexapro use.

Enhancing HRV while using Lexapro involves a multifaceted approach that considers both medication-related and lifestyle factors. In most cases, lifestyle factors dominate and play a significant role in optimizing both mental health and cardiovascular well-being.

Engaging in regular physical activity has been linked to improved HRV and cardiovascular health. Additionally, adopting a balanced and heart-friendly diet rich in fruits, vegetables, whole grains, and lean protein can positively impact cardiovascular health and may indirectly influence HRV. Thus, it is advisable to consult with a physiotherapist and a dietician for a suitable exercise and diet plan, respectively.

It is also advisable to prioritize quality sleep, as it plays a crucial role in mental and cardiovascular health. Reduce the consumption of stimulants, such as caffeine and tobacco, before bedtime, as stimulants not only affect sleep but can also negatively influence HRV. Consult with your healthcare provider to determine appropriate limits based on your health profile.

You may also utilise wearable devices or other methods for regular monitoring of HRV. This allows you to track changes over time and assess the effectiveness of the combined approaches.

It’s essential to approach these strategies as a part of a holistic healthcare plan, and any adjustments should be made in consultation with your healthcare provider to ensure they align with your specific needs and circumstances.

Does long-term Lexapro’s use impact HRV?

Individual responses to Lexapro can differ due to factors such as genetic variations, overall health, and comorbidities. Long-term use of Lexapro may contribute to changes in the autonomic nervous system, influencing HRV for some individuals. However, the specific nature of these changes and variability among different people is not fully understood.

It is essential to recognize that HRV itself can fluctuate naturally over time, and establishing a clear cause-and-effect relationship between long-term Lexapro use and changes in HRV requires a judicious approach. 

Individuals considering long-term use of Lexapro and its potential effects on HRV should engage in informed discussions with their healthcare providers. Monitoring HRV periodically and discussing any concerns or observed changes can help in tailoring treatment plans to individual needs. 


In my opinion, Lexapro (escitalopram) does not affect HRV. However, this relationship is complex, and it is influenced by various factors such as cardiovascular diseases, age, drug-drug interactions and duration of use of antidepressant medications such as Lexapro. If you have concerns, you should immediately consult your healthcare provider for the right course of action. 

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Fiani D, Campbell H, Solmi M, Fiedorowicz JG, Calarge CA. Impact of antidepressant use on the autonomic nervous system: A meta-analysis and systematic review. Eur Neuropsychopharmacol. 2023 Jun;71:75-95. doi: 10.1016/j.euroneuro.2023.03.013. Epub 2023 Apr 17. PMID: 37075594.


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