Text

Background: Music has long been used therapeutically, however its ability to alter human physiology and thereby influence pharmacokinetics (PK) and pharmacodynamics (PD) of medicines, remains underexplored. Because music modulates autonomic balance, neuroendocrine activity, emotional state, and brain-wave patterns, it may serve as an overlooked physiological factor capable of shaping clinically relevant drug effects.

Objectives: This study aims to summarize current evidence on how music-induced physiological changes may affect PK and PD, highlighting music as a potential adjunct that can modify drug efficacy and patient outcomes.

Methods: A literature search was conducted to identify studies linking music exposure with PK/PD in clinical and experimental settings.

Results: Available data indicate that music can alter sedative and anesthetic effects primarily through pharmacodynamic mechanisms. Clinical trials consistently show that patients exposed to calming music before or during anesthesia require lower doses of propofol, midazolam, and opioids. These effects are linked to music’s capacity to enhance parasympathetic activity, reduce sympathetic arousal, and shift cortical rhythms, as evidenced by EEG alterations in alpha and theta bands. Music’s physiological effects (e.g., reduced cortisol, lower heart rate and blood pressure, diminished anxiety, and improved emotional regulation) may also influence PK including absorption, distribution, hepatic perfusion, and clearance. Although direct human data on plasma levels or metabolism are lacking, established PK/PD principles support music as a plausible non-pharmacological modulator of drug action and disposition.

Conclusions: By altering autonomic, emotional, and neuroendocrine physiology, music may indirectly affect PK/PD behavior. Its role as a physiological modulator warrants systematic investigation within pharmacology.