Some antidepressants hit harder: study suggests

Depression is a silent killer, a fact widely acknowledged in most societies but still in its primitive phase in the developing world, where it remains stigmatized and seeking medical care is often discouraged.

Those who are on medication with antidepressants know the familiar warnings: drowsiness, appetite changes, headaches, and more.

While some drugs trigger rapid weight gain, heart rate spikes, or blood pressure shifts, others remain largely harmless.

The new study suggests that its findings could influence how doctors prescribe these antidepressants, which are used by nearly one in five adults in Europe and North America.

Toby Pillinger, one of the study authors, noted that “not all antidepressants are equal in their physical impact."

He added, “The problem is that up until now, we haven’t had that comparative data available to guide those decisions.”

The study, which was published in The Lancet Medical Journal, is the first to establish specific side effects to individual antidepressant medications.

Pillinger's team conducted a large-scale analysis by combining data from 151 clinical studies and 17 FDA reports.

This research, which tracked nearly 59,000 individuals taking either antidepressants or a placebo for about eight weeks, examined 30 different drugs.

These included widely-used SSRIs (sertraline, escitalopram) and other antidepressants like mirtazapine and amitriptyline.

The study revealed major differences in physical side effects between antidepressants.

For instance, the weight gain associated with maprotiline was about 4 kg greater than with agomelatine, and fluvoxamine affected heart rate more than 21 beats per minute faster than nortriptyline.

The researchers estimated that nearly half of all patients taking certain antidepressants, like maprotiline and amitriptyline, experienced a "clinically important" amount of weight gain.

The researchers concluded that SSRIs are "relatively benign" compared to other antidepressants.

They cautioned that adverse physical effects are a common reason for treatment non-adherence, which in turn can lead to a significant deterioration in a patient's psychiatric condition.