Scientists have warned that this large difference in side effects could affect people’s health and their ability to continue using the medicine.
For the first time, the side effects of different antidepressants have been classified, revealing important differences between the drugs.
The researchers analyzed the impact of the drugs on patients in the first eight weeks after starting treatment: some led to increases of up to 2 kg and changes in heart rate of up to 21 beats per minute.
Data from the latest disease mapping carried out by the WHO indicates that 5.8% of the Brazilian population suffers from depression, the equivalent of 11.7 million Brazilians.
Scientists have warned that this large difference in side effects could affect people’s health and their ability to continue using the medicine.
They stressed that no one should stop treatment on their own, but argued that antidepressants should be more precisely tailored to each individual’s needs.
“There are big differences between [os antidepressivos]and this is important not only for individual patients, but also because large numbers of people use them, so even modest changes can have a big impact on the whole population,” said researcher Professor Oliver Howes.
Antidepressants have always been known to affect physical health. The study by King’s College London and the University of Oxford is the first to create a ranking that allows the effects of drugs to be easily compared.
The team analyzed 151 studies on 30 drugs commonly used to treat depression, involving more than 58,500 patients.
Not everyone develops side effects, but on average results are achieved published in the medical journal The Lancet demonstrated that:
- An eight-week treatment with agomelatine was associated with a reduction in body weight of 2.4 kg, compared to maprotiline, which led to an increase of almost 2 kg;
- There was a 21 beats per minute difference in heart rate between fluvoxamine, which slowed the heart rate, and nortriptyline, which speeded it up;
- An 11 mmHg difference in blood pressure was observed between nortriptyline and doxepin.
“Clearly, no two antidepressants are the same,” said Dr. Atheeshaan Arumuham of King’s College London.
These differences can add up in ways that become clinically relevant, including an increased risk of heart attack or stroke.
This means that, even with the same diagnosis, different patients may benefit more from different antidepressants, depending on their preferences and other health conditions.
Dr Toby Pillinger told BBC Radio 4’s Today programme: “Most of the studies we looked at were relatively short. We’re talking about eight weeks, and yet we saw big changes in physical health parameters which we think have clinical relevance.”
“The last thing I want is for this news to scare people. I want this to empower people, encourage them to take initiative and participate in decisions together with their doctor,” he added.
Which antidepressant is best for me?
In a hypothetical scenario, Sarah, 32, John, 44, and Jane, 56, were given the same diagnosis of depression and advised to take antidepressants.
But each of them wants to avoid different side effects.
Pillinger, who analyzed the examples for the BBC, says each will be recommended a different drug.
Sarah, 32, who has been diagnosed with depression and wants to avoid weight gain;
Dr. Toby Pillinger recommends that Sarah use an antidepressant that does not cause weight gain, such as agomelatine, sertraline, or venlafaxine, rather than amitriptyline or mirtazapine, which are more likely to increase body weight.
John, 44, also suffers from depression and his priority is to avoid the side effects that worsen his high blood pressure;
According to the specialist, you should avoid drugs such as venlafaxine, amitriptyline or nortriptyline, which increase blood pressure, and opt for options such as citalopram, escitalopram or paroxetine.
Jane, 56, has the same diagnosis and high cholesterol;
The medical recommendation is to avoid venlafaxine, duloxetine and paroxetine. Citalopram or escitalopram are more cholesterol-neutral options and may be better suited for you.
Defense for the use of generic and low-cost drugs
Researchers say it’s too simplistic to say there are “good” and “bad” antidepressants. Although amitriptyline increases weight, heart rate, and blood pressure, it also helps relieve pain and sleep problems.
In general, the most prescribed class of antidepressants – SSRIs (selective serotonin reuptake inhibitors), such as paroxetine, citalopram, escitalopram, and sertraline – tend to cause fewer physical side effects.
Fluoxetine – an SSRI also known as Prozac – was associated with weight loss and increased blood pressure in the study.
Professor Andrea Cipriani, of Oxford University, said it was “impossible” to say how many of the millions of people taking antidepressants should use a different medicine.
He explained, however, that there was a preference for “low-cost generic medicines”, which meant that 85% of antidepressant prescriptions in the UK were concentrated on just three drugs: citalopram, sertraline and fluoxetine, all of the SSRI class.
According to Cipriani, applying the study’s conclusions “would drastically reduce this 85%”, allowing “more people to have access to better care”.
Researchers are developing a free online tool to help doctors and patients choose the most appropriate medicine.
However, this would still require a significant cultural change within the UK National Health Service.
The study only looked at what happened in the first eight weeks after starting treatment. Dr Pillinger said that “complementary data” indicated that the changes observed in the short term “should persist”, but that this still needed to be adequately tested.
Dr Prasad Nishtala, of the University of Bath, who was not involved in the research, called the findings “groundbreaking and valuable”.
According to him, “in the real world, where patients often use antidepressants for months or years, the accumulated risks are probably greater, especially among those suffering from chronic depression.”
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
