Antidepressant side effects vary depending on the drug : Shots

Doctors have long known that antidepressants have side effects on the cardiovascular system and metabolism.

But a large-scale analysis by a team of UK researchers brought together data from more than 150 clinical trials for the first time to compare the physical side effects of dozens of antidepressants.

Studying, published in Lancet this week details how each drug can affect weight, blood pressure, heart rate, cholesterol and other areas of health.

The end result is something like a “sports chart” for 30 different antidepressants based on their side-effect profiles, says the lead author. Dr. Toby Pillingerpsychiatrist at King's College London.

“This has never been done on this scale before, and no one has ever put specific numbers on how much weight you'll gain or how much your cholesterol will go up,” he says.

The results are based on existing data, mostly from 8-week drug studies that included more than 58,000 patients.

The most commonly prescribed antidepressants in the United States are: Selective serotonin reuptake inhibitorsor SSRIs such as Zoloft and Prozac. — according to the analysis, had fewer physical side effects.

Other drugs, especially some of the older drugs, have been shown to have more significant effects.

For example, a person taking nortriptyline tricyclic antidepressantcould have an average increase in heart rate 20 beats higher than that of the SSRI fluvoxamine. For other medications, the expected weight change may be four pounds gain or loss.

Pillinger says the intention is not to single out some antidepressants as being better than others.

“It may be that one medicine that is very bad for one person is actually very good for another. I think that's the message, not naming and shaming certain drugs,” he says.

Pillinger hopes the data will help prescribers and their patients make individual decisions about the best medicine.

In fact, he and his colleagues created free digital tool it is already being used by doctors around the world to create a “menu” of options based on the patient's health status and the side effects they would most like to avoid.

Dr. Nina Kragulyakan Ohio State University professor who was not involved in the study says the study was well done and largely encouraging.

“What surprised me about this study is that the side effects are not that serious,” says Kraguliak, who is also chairman of the American Psychiatric Association's research board.

However, she emphasizes that “side effects alone should not drive clinical decision,” since study results ultimately reflect the average, not the individual patient.

“Side effects do not occur in every patient and are not necessarily what keeps people from taking medications,” she says.

The study does have some notable limitations.

Although many people take these drugs for months or years, the data has mostly come from 8-week randomized controlled trials, which are the most common.

Some of the significant side effects that cause some people to stop taking antidepressants have not been assessed, the scientists said. Dr. David HellersteinProfessor of Psychiatry at Columbia University.

He points to effects on sexual function, gastrointestinal problems and “emotional numbing” – a feeling of numbness of feelings – all common complaints that go unaddressed.

Most of the side effects detailed in the study are already well known, although he believes the work will still be a “useful touchstone” for patients and prescribers.

“In general, most of these drugs appear to be quite safe on many physical parameters, especially the newer drugs such as SSRIs and SNRIs (serotonin-norepinephrine reuptake inhibitors),” he says.

But for some groups of people, side effects can be significant, he warns, “and may influence which drug a doctor chooses or which drug a patient chooses.”

And he notes that side effects are not always a disadvantage.

Hellerstein has a patient who lost significant weight due to depression, meaning that an antidepressant that also resulted in some extra weight would actually be “healthy.”

“I would say this is not a side effect. This is the benefit of treatment,” he says.