Overview
- Researchers pooled 151 placebo-controlled trials and 17 FDA reports covering 58,534 participants to compare 30 antidepressants over roughly eight weeks.
- Weight change varied by about 4 kg across drugs, with agomelatine linked to an average 2.44 kg loss and maprotiline to a 1.82 kg gain.
- Heart-rate effects differed by more than 20 beats per minute, from an average 8 bpm decrease with fluvoxamine to a 13.8 bpm increase with nortriptyline, alongside over 10 mmHg variation in blood pressure, including decreases with nortriptyline and increases with doxepin.
- SSRIs generally showed fewer short-term physical side effects, with sertraline associated with modest weight loss and a slight heart-rate reduction, whereas tricyclics like amitriptyline and SNRIs such as venlafaxine showed less favorable cardiometabolic profiles.
- Authors stress the analysis captures only early effects and call for shared decision-making, routine monitoring, and further long-term research, with a decision-support tool in development and guidance not to stop medication without medical advice.