For the first time, scientists have compared how different antidepressants affect physical health – and the results surprised even the researchers themselves.
A team from King’s College London and Oxford University analysed data from 151 studies involving more than 58,000 patients.
They assessed the effects of 30 of the most popular antidepressants over the first eight weeks of treatment – and found that some drugs can change heart rate by almost 21 beats per minute and add up to two kilograms of weight.
Around eight million people take antidepressants in the UK alone, so even small differences in side effects can make a big difference to health.
Researchers warn: these differences could affect not only how you feel, but also whether you take antidepressants as a placebo Such differences, say the scientists, could be clinically important because they affect your risk of heart disease or even stroke.
“Most of the studies we analysed lasted only eight weeks, but even in that short time we saw significant changes in physical performance. This cannot be ignored,” notes co-author Dr Toby Pillinger in a commentary for the BBC.
At the same time, the scientists emphasise: the aim of the study is not to scare people, but to help them better understand their treatment.
” I want these data to motivate people to be more active – to ask questions, discuss options with their doctor and make decisions together, rather than just blindly following a prescription,” adds Pillinger.
How to choose “your” antidepressant
Imagine three patients:
Sarah, 32, it’s important not to gain weight.
John, 44, should avoid medications that raise blood pressure.
Jane, 56, should control her cholesterol levels.
According to the study, Sarah could be approached with agomelatine, sertraline or venlafaxine. John is on citalopram or escitalopram, and Jane is on the same drugs because they are neutral to cholesterol.
There are no “bad” antidepressants.
Scientists say it’s wrong to divide antidepressants into “good” and “bad”. It all depends on the person and their condition.
For example, right now they’re taking the “wrong” antidepressant.
In Britain, cheaper generics are often prescribed, and 85 per cent of all prescriptions are for just three names – citalopram, sertraline and fluoxetine.
“If the individual characteristics of each patient are taken into account, this figure should drop significantly – and people will be able to get the treatment that really suits them,” he explains.
The research team is now creating a free online tool to help doctors and patients work together to choose the best drug. But to do this, they add, they will have to change the approach in the healthcare system.
The authors also clarify that their analysis only covered the first eight weeks of treatment. While other evidence suggests that the effects may last longer, this has yet to be proven.
Prasad Nishtala of the University of Bath, questions,” Nishtala emphasises.