Millions of people worldwide rely on antidepressants to manage mental health conditions such as depression and anxiety. While these medications can be highly effective, they also come with a range of physical side effects, including weight gain, changes in heart rate, and altered blood pressure. A recent study has highlighted that not all antidepressants are created equal in terms of their physical impacts on the body.
The analysis, conducted by a team of researchers, examined 151 randomized trials involving 58,534 participants and 30 different antidepressants. The study revealed significant differences in how these drugs affect weight, heart rate, cholesterol levels, and blood pressure. For the millions who depend on these medications, understanding these differences is crucial.
Understanding the Study’s Findings
The research employed a method known as network meta-analysis, which allows for the simultaneous comparison of multiple treatments. This approach created a “league table” ranking the antidepressants from best to worst based on their physical health outcomes.
Even after just eight weeks of treatment, the physical effects varied significantly. For instance, the antidepressant agomelatine was associated with an average weight loss of 2.5kg, whereas maprotiline led to a gain of nearly 2kg. Heart rate effects also differed, with fluvoxamine lowering heart rate by about eight beats per minute and nortriptyline increasing it by around 14 beats per minute, a difference of more than 20 beats per minute between drugs.
Weight effects varied markedly between drugs. For example, people taking the antidepressant agomelatine lost around 2.5kg on average, whereas those on maprotiline gained nearly 2kg.
Systolic blood pressure showed a spread of more than 11mmHg between doxepin and nortriptyline. Additionally, several antidepressants, including paroxetine, venlafaxine, desvenlafaxine, and duloxetine, were linked to higher cholesterol levels, with duloxetine also associated with elevated blood sugar levels.
The Importance of Personalized Prescribing
The study underscores the need for personalized prescribing of antidepressants. For years, discussions around these medications have focused on their efficacy and side effects. However, the findings suggest a more pertinent question: which drug is best suited to an individual, considering their physical health and priorities?
For individuals with conditions such as obesity, diabetes, or hypertension, choosing an antidepressant with a neutral effect on weight, blood sugar, and blood pressure is crucial. Conversely, for someone underweight with low blood pressure, the trade-offs may differ. The right choice depends on the patient’s specific circumstances.
The data shows that antidepressants are not interchangeable. For someone with obesity, diabetes or hypertension, choosing an antidepressant that has a more neutral effect on weight, blood sugar and blood pressure is sensible.
Doctors face the challenge of considering two dozen different antidepressants and their potential side effects. To aid in this process, the researchers developed a freely available tool that helps doctors and patients collaboratively select the most appropriate antidepressant. This tool allows patients to prioritize which side effects they wish to avoid, integrating these preferences with side-effect databases to produce a personalized ranking of options.
Looking Ahead: Implications for Treatment
While antidepressants remain effective for many, the study highlights that they are not all the same. There is now high-quality evidence showing that their effects on weight, blood pressure, heart rate, and blood sugar differ in clinically meaningful ways. This calls for a shift in focus from debating the merits of antidepressants as a group to tailoring treatment to the individual.
Tools like the one developed by the researchers make personalized prescribing possible, ensuring that patients receive antidepressants that are both safer and better tolerated. As the medical community continues to explore the long-term effects of these medications, the importance of routine monitoring and patient-centered care cannot be overstated.
Ultimately, the goal is to match the right medicine to the right person, fostering shared decision-making between doctors and patients. This approach not only enhances treatment outcomes but also empowers patients in their healthcare journey.
Courtesy of The Conversation. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style, and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).
