A groundbreaking study has ranked the physical health effects of different antidepressants for the first time, revealing significant variations between medications. Researchers analyzed how these drugs impacted patients in the first eight weeks of treatment, showing some could lead to weight changes of up to 2 kilograms or affect heart rate by as much as 21 beats per minute.With around eight million people in the UK currently taking antidepressants, experts say these findings could play an important role in ensuring prescriptions are better tailored to individuals. The research emphasizes that no one should stop taking their medication without consulting a doctor, but that antidepressants should be chosen more carefully based on personal health profiles.
According to Professor Oliver Howes, small changes in physical health can have a major effect across the population since so many people rely on these treatments. Conducted by teams from King’s College London and the University of Oxford, this is the first study to create a clear ranking system comparing antidepressant effects on physical health. The analysis included 151 studies involving more than 58,500 patients and covered 30 widely prescribed antidepressants. The results, published in The Lancet medical journal, found striking differences between medications:
Antidepressants Ranked by Their Physical Health Effects for the First Time
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Dr. Atheeshaan Arumuham from King’s College London said these differences are clinically important, as they could increase the risk of cardiovascular issues such as heart attacks or strokes. This means patients with the same diagnosis might need very different antidepressants depending on their overall health and preferences. Dr. Toby Pillinger, one of the study authors, noted that while the research focused on an eight-week period, the health changes observed could have long-term implications. He encouraged patients to view this information as empowering and to discuss their treatment options openly with healthcare professionals. For instance, people who want to avoid weight gain may benefit from antidepressants like agomelatine, sertraline, or venlafaxine. Those with high blood pressure could consider options such as citalopram, escitalopram, or paroxetine, while individuals with high cholesterol may respond better to medications like citalopram or escitalopram. The researchers cautioned against labeling any antidepressant as strictly good or bad. Drugs such as amitriptyline, despite increasing weight and blood pressure, can also help with pain and sleep problems. In general, SSRIs like paroxetine, citalopram, escitalopram, and sertraline were found to cause fewer physical side effects overall.
Fluoxetine, better known as Prozac, was associated with slight weight loss but increased blood pressure. Professor Andrea Cipriani from the University of Oxford said that implementing these findings could transform prescribing habits, reducing reliance on generic options like citalopram, sertraline, and fluoxetine, which currently make up about 85% of UK prescriptions. The research team is now developing a free online tool to help doctors and patients choose the most suitable antidepressant based on individual health data. Experts believe this could mark a major shift in mental health treatment, ensuring the physical health effects of antidepressants are considered as carefully as their psychological benefits.
