Currently, about 85% of antidepressant prescriptions in the UK include only three drugs: Citalopram, Sertraline, and Fluoxetine.
Currently, about 85% of antidepressant prescriptions in the UK include only three drugs: Citalopram, Sertraline, and Fluoxetine. However, with the release of new research findings, prescriptions are expected to become more diverse and tailored to each patient’s individual characteristics.
New Review and Ranking of Antidepressant Physical Side Effects – October 2025
For the first time, researchers from the University of Oxford and King’s College London have compared and ranked the physical side effects of over 30 antidepressant medications. The results, published in The Lancet, show significant differences among these drugs, which can directly influence treatment decisions.
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Maprotiline led to an average weight gain of about 2 kg.
Key Findings of the Study
In a review of over 58,000 patients across 151 clinical studies, researchers found that:
Agomelatine caused an average weight loss of 2.4 kg.
Maprotiline led to an average weight gain of about 2 kg.
The difference between Fluvoxamine (decreasing heart rate) and Nortriptyline (increasing heart rate) was about 21 beats per minute.
Between Nortriptyline and Doxepin, there was an 11 mmHg difference in blood pressure.
According to the researchers, these combined effects could be clinically significant and may even increase the risk of heart attack or stroke.
Why Antidepressant Choice Should Be Personalized
According to Professor Oliver Howes, no two antidepressants have exactly the same effects. Each person should receive medication tailored to their physical health, weight, blood pressure, and lifestyle.
For example:
Sarah (32) is concerned about weight gain.
John (44) has high blood pressure.
Jane (56) has elevated cholesterol.
In each case, the doctor would prescribe a different medication to minimize unwanted side effects.
Researchers emphasize that no antidepressant is inherently “good” or “bad.”
Amitriptyline may increase weight and blood pressure but can help with pain and sleep quality.
SSRIs such as Citalopram, Sertraline, Escitalopram, and Paroxetine generally have fewer physical side effects.
Fluoxetine (Prozac) can cause weight loss but may raise blood pressure.
The Future of Personalized Treatment
Currently, 85% of antidepressant prescriptions in the UK still consist of Citalopram, Sertraline, and Fluoxetine. However, based on these findings, future prescriptions are expected to be more personalized and diverse.
Researchers are also developing a free online tool to help doctors and patients choose the best antidepressant based on individual health factors.
Important Warning
No one should stop taking antidepressants without consulting their doctor. This study aims to increase awareness and encourage patients to play a more active role in their treatment decisions.
Amitriptyline may increase weight and blood pressure but can help with pain and sleep quality.
Summary
The physical effects of antidepressants vary greatly between drugs.
Choosing the right medication should depend on individual needs and medical conditions.
Generic or low-cost options are not necessarily the best for everyone.
If you or someone you know is using antidepressants, talk to your doctor about potential side effects and alternative options.
Sexual Side Effects of Antidepressants – PubMed Review
According to a study published in The Medical Journal of Australia, the use of antidepressants especially Selective Serotonin Reuptake Inhibitors (SSRIs) and similar medications can have notable impacts on sexual function, including:
Reduced libido (sexual desire)
Difficulties with arousal and sexual stimulation
Delayed or absent orgasm
Erectile or ejaculation problems in men
Research has reported that 30% to 60% of patients treated with SSRIs may experience some form of sexual dysfunction.
Generic or low-cost options are not necessarily the best for everyone.
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