Overview
- The network meta-analysis pooled 151 randomized trials with more than 58,000 participants comparing 30 commonly used drugs over roughly eight weeks.
- Average changes varied widely, including about 2.4 kg weight loss with agomelatine versus roughly 2 kg gain with maprotiline, and an approximate 11 mmHg blood-pressure gap between some tricyclics.
- Heart rate effects diverged markedly, with fluvoxamine lowering pulse and nortriptyline raising it by about 21 beats per minute.
- NHS data show 92.6 million antidepressant prescriptions were issued to an estimated 8.89 million patients in England in 2024/25, with drug-level patterns reported for widely used agents such as sertraline and amitriptyline.
- Experts and professional bodies urge routine checks, medication reviews and shared decision-making, noting the findings reflect short-term averages and that patients should consult clinicians if side effects persist or worsen.