Yes. Many medicines change your heart rate, and some change heart rate variability (HRV) too. Beta-blockers tend to raise HRV, some antidepressants lower it, and stimulants speed up the heart. A shift after you start a medicine is usually the drug doing its job, and it is never a reason to stop or change your dose.
Why medicines can move HRV
HRV reflects the balance between the two branches of the nervous system that steer your heart rate: the calming branch, which slows the heart, and the “alert” branch, which speeds it up through adrenaline. A medicine that acts on either branch, or simply changes how fast your heart beats, can change the number your app shows. The lesson on what moves HRV covers the other factors that do the same.
Medicines that are known to affect HRV
| Medicine group | What studies found |
|---|---|
| Beta-blockers | Slow the heart; tended to raise HRV in trials |
| Non-dihydropyridine calcium channel blockers (such as verapamil and diltiazem) | Tended to raise HRV in trials |
| ACE inhibitors, thiazide diuretics | Little effect on HRV |
| Tricyclic antidepressants | Lower HRV |
| SSRIs and other newer antidepressants | Less clear: no clear effect in one review, small drops with some antidepressants in another |
| Some antipsychotics | Small drops in HRV |
| Stimulants for ADHD | Raise resting heart rate Resting heart rate How many times your heart beats per minute while you are fully at rest. For adults it is usually 60 to 100 beats per minute, and lower in well-trained athletes. More about Resting heart rate in adults; HRV effect unclear |
Blood pressure and heart medicines
Beta-blockers slow the heart by blocking the effect of hormones such as adrenaline (HSE). A 2025 review gathered 29 randomised trials with 2,230 people with high blood pressure (Sehgal and colleagues, 2025). Beta-blockers and non-dihydropyridine calcium channel blockers consistently raised HRV and the measures linked to the calming branch. Angiotensin receptor blockers raised HRV in people who also had metabolic syndrome, and alpha-blockers showed small gains. ACE inhibitors and thiazide diuretics made little difference. The trials varied a lot in design and the reviewers did not rate their quality, so treat these as broad patterns.
A higher HRV on a beta-blocker reflects the drug’s effect on your heart rhythm. It does not mean you are fitter or recovering better.
Antidepressants and other mental health medicines
A 2010 review of people with depression found that tricyclic antidepressants, an older group, lowered HRV, while SSRIs and two other antidepressants had no clear effect (Kemp and colleagues, 2010). A larger 2016 review found smaller but real drops in HRV with some antidepressants and some antipsychotics (Alvares and colleagues, 2016). The same review found lower HRV in people with these conditions who took no medicine, so the condition itself plays a part. See does depression lower HRV? for more.
Stimulants
Stimulants used for ADHD raise heart rate. A review of 10 trials in adults found that resting heart rate went up by about 6 beats a minute on average in people taking a stimulant (Mick and colleagues, 2013). For HRV itself, a 2026 review of methylphenidate in children and teenagers found no clear change in resting HRV, but rated the evidence as very low certainty (Gianini and colleagues, 2026). Studies in adults are scarce.
What to do with your own data
- Never adjust a medicine for your HRV. Do not stop, start, skip or change the dose of anything because of a wearable reading. Some medicines, including beta-blockers, should not be stopped without a doctor’s advice (HSE).
- Tag the start date. When you start, stop or change a medicine on your doctor’s advice, note it in your app. Expect a new baseline Baseline Your own usual HRV level and range, built from weeks of readings taken the same way. Comparing a reading with your baseline says more than comparing it with other people. More about Baseline and compare from that point on.
- Don’t compare across a change. A month on a beta-blocker and a month before it are not like for like. See why your HRV might suddenly be high for other causes of a jump.
- Tell your doctor what you notice. A steady drop in resting heart rate or a big change in HRV after starting a medicine is useful information to bring to an appointment.
When to get help
Get urgent help if you feel faint, very dizzy or short of breath, or have chest pain or an irregular heartbeat, especially after starting or changing a heart medicine. Very slow heart rate can show up as dizziness or trouble breathing (HSE). Talk to your doctor or pharmacist if side effects bother you or do not go away, whatever your HRV shows.