Overview
- A network meta-analysis of 151 placebo-controlled trials and 17 FDA reports, covering more than 58,000 participants and 30 antidepressants, compared short-term physiological effects over roughly eight weeks.
- The review found an approximate 4 kg spread in average weight change between drugs, a heart-rate difference exceeding 20 beats per minute, and a blood-pressure variation of more than 10 mmHg across certain medications.
- Agomelatine was associated with short-term weight loss (about 2.4–2.5 kg) while maprotiline showed weight gain (around 2 kg), fluvoxamine reduced heart rate by about 8 bpm, and nortriptyline increased it by about 14 bpm.
- Amitriptyline was linked to average weight gain of roughly 1.6 kg, a heart-rate rise of about 9 bpm, and increases in systolic and diastolic blood pressure, whereas SSRIs generally showed fewer short-term physical side effects in this analysis.
- Authors and commentators called for shared decision-making, updates to prescribing guidance, and routine checks of weight, blood pressure and cardiovascular risk, noting the findings reflect short-term use only and highlighting ongoing work on decision-support tools amid extensive prescribing in England.