A British study found that antidepressants differ in side effects such as weight gain Medical research
People taking certain types of antidepressants can gain up to 2 kg (4.5 pounds) of weight during the first two months of treatment, while patients taking other medications can lose as much or more, according to a large review of potential side effects.
The research, conducted by academics at King’s College London and the University of Oxford, found that while some antidepressants can cause noticeable changes in body weight, heart rate and blood pressure, others do not cause such physical changes.
Researchers are calling for antidepressant treatment guidelines to be updated to reflect these findings.
Antidepressants are medications that can help treat mental health conditions such as depression and anxiety, and are recommended for use for up to two years in most cases.
The study included an analysis of data from 151 clinical studies on antidepressants, and compared the physical health effects of 30 different antidepressants in more than 58,000 people.
The researchers found that there was significant variation in side effects between different medications, although most of the studies analyzed included only eight weeks of antidepressant use.
For example, there was a difference of up to 4 kg in average weight change between some medicines: the equivalent of about 2.5 kg of weight loss when taking agomelatine, compared to about 2 kg of weight gain with maprotiline. Weight gain occurred in nearly half of people prescribed drugs such as maprotiline or amitriptyline, while more than half of those taking agomelatine experienced weight loss.
The study also found a 21 beats per minute difference in heart rate between people taking fluvoxamine and nortriptyline. An 11 mm Hg difference in blood pressure was found between nortriptyline and doxepin.
Dr Toby Bellinger, clinical lecturer at KCL, said: “Antidepressants are among the most widely used medicines in the world. While many people benefit from them, these medicines are not all the same – some can lead to significant changes in weight, heart rate and blood pressure in a relatively short period.”
After promoting the newsletter
“Our findings show that SSRIs [selective serotonin reuptake inhibitors]the most prescribed type of antidepressant, tends to have fewer physical side effects, which is reassuring. But for others, closer monitoring of physical health may be warranted. The goal is not to deter use, but rather to enable patients and doctors to make informed choices and encourage personalized care.
Andrea Cipriani, Professor of Psychiatry at the University of Oxford, said: “Our findings underscore the importance of shared decision-making, the collaborative process by which patients are supported by clinicians to reach a decision about their treatment, bringing together their preferences, personal circumstances, goals, values and beliefs. This must be the way forward in the NHS and globally.”