Expert Witness Journal Issue 64 December 2025 - Flipbook - Page 70
Research Establishes Wide Variation in
Physical Side-e昀昀ects of Antidepressants
by King’s College London
Antidepressants di昀昀er widely in how they a昀昀ect the
body, according to new research from the Institute
of Psychiatry, Psychology & Neuroscience (IoPPN)
at King’s College London, in collaboration with the
University of Oxford.
The study also estimated that weight gain occurred
in nearly half of people prescribed drugs such as
maprotiline or amitriptyline, whereas over half of
those taking agomelatine experienced weight loss.
Similarly, there was a 21-beat-per-minute di昀昀erence
in heart rate between 昀氀uvoxamine and nortriptyline.
Published in The Lancet1, the large-scale study
found that some antidepressants can cause clinically
relevant changes in body weight, heart rate, and
blood pressure within just a few weeks, while others
appear largely neutral in their physical e昀昀ects.
Researchers are calling for antidepressant treatment
guidelines to be updated to re昀氀ect these 昀椀ndings.
By contrast, some commonly prescribed SSRIs —
the most commonly used type of antidepressant —
showed little or no adverse impact on these physical
health measures.
Dr Toby Pillinger, Academic Clinical Lecturer at the
Institute of Psychiatry, Psychology & Neuroscience,
Consultant Psychiatrist at the South London and
Maudsley NHS Foundation Trust, and the study’s
senior author said,
Up to 20 per cent of adults in Europe and North
America are prescribed antidepressants to treat a
range of conditions. While these medications are
known to cause physical side e昀昀ects, the degree to
which these alterations occur in patients treated with
di昀昀erent antidepressants was previously unclear.
Researchers in this study analysed the data from
151 di昀昀erent studies, comparing the physical health
e昀昀ects of 30 di昀昀erent antidepressants across more
than 58,000 people.
“
Our 昀椀ndings show that SSRIs, which are the most
prescribed type of antidepressant, tend to have
fewer physical side-e昀昀ects, which is reassuring. But
for others, closer physical health monitoring may be
warranted.”
- Dr Toby Pillinger,
Academic Clinical Lecturer at the IoPPN, Consultant
Psychiatrist at the South London and Maudsley NHS
Foundation Trust, and the study’s senior author
“
Our 昀椀ndings show that SSRIs, which are the most
prescribed type of antidepressant, tend to have
fewer physical side-e昀昀ects, which is reassuring. But
for others, closer physical health monitoring may be
warranted.”
“
The aim isn’t to deter use, but to empower patients
and clinicians to make informed choices and to
encourage personalised care.”
Professor Andrea Cipriani, Professor of Psychiatry
at the University of Oxford, Director of the NIHR
Oxford Health Clinical Research Facility and the
study’s last author said,
They found notable variation between drugs,
even over relatively short treatment periods —
most studies involved around eight weeks of
antidepressant use. For example, there was up to
a 4-kilogram di昀昀erence in average weight change
between some drugs, equivalent to around 2.5 kg of
weight loss with agomelatine compared with about 2
kg of weight gain with maprotiline.
EXPERT WITNESS JOURNAL
“
Antidepressants are among the most widely used
medicines in the world. While many people bene昀椀t
from them, these drugs are not identical – some can
lead to meaningful changes in weight, heart rate, and
blood pressure in a relatively short period.”
“
“
67
Most clinical decisions – especially in mental health
– are still made by physicians with little input from
patients.”
Our results emphasise the importance of shared
decision making, the collaborative process through
which patients are supported by the clinicians to reach
DECEMBER/JANUARY 2025-2026
