A major UK study has found that different antidepressants can cause significant variations in side-effects such as weight change, heart rate, and blood pressure — highlighting the need for more personalised treatment choices.
Researchers from King’s College London and the University of Oxford analysed data from 151 clinical trials involving more than 58,000 participants across 30 types of antidepressants. They discovered that while some drugs lead to weight gain, others can cause weight loss or have minimal physical effects.
For instance, patients on maprotiline gained an average of 2kg within two months, while those on agomelatine lost around 2.5kg. Nearly half of those taking maprotiline or amitriptyline experienced weight gain, compared with over half of agomelatine users who lost weight.
Differences were also observed in cardiovascular effects — with a 21 beats-per-minute gap in heart rate between fluvoxamine and nortriptyline, and an 11 mmHg variation in blood pressure between nortriptyline and doxepin.
Dr Toby Pillinger from King’s College London said the findings show that while SSRIs generally have fewer physical side-effects, some antidepressants can cause “meaningful changes” that warrant closer monitoring.
Professor Andrea Cipriani of Oxford added that the results underscore the importance of shared decision-making, ensuring patients and clinicians choose medications that best align with individual needs and health goals.
