Khaberni - A new scientific study has shown that antidepressants, which are drugs used to treat depression, anxiety, and other health conditions, can cause a wide range of physical side effects that vary depending on the type of drug used, including effects on body weight.
The study, published in The Lancet journal, pointed out noticeable differences up to about four kilograms in weight between some drugs, finding that "Agomelatine" could lead to a loss of about 2.5 kilograms on average, while "Maprotiline" might cause an increase of about two kilograms.
The researchers stressed that these findings should not deter patients from taking antidepressants, which are still considered effective and vital treatments for psychological disorders, but they highlight the importance of tailoring treatment prescriptions according to the health condition of each individual and their personal preferences.
The study compiled results from 151 clinical trials and 17 reports from the U.S. Food and Drug Administration (FDA), involving more than 58,000 participants, to assess the impact of 30 different types of antidepressants on the body over an average treatment period of eight weeks.
The results also showed variations in heart rate and blood pressure, reflecting the diverse bodily responses to different types of medications even within the same therapeutic category.
The analyses also indicated that antidepressants can cause differences exceeding 20 beats per minute in heart rate between one drug and another, noting that "Fluvoxamine" could reduce the heart rate by about 8 beats per minute, whereas "Nortriptyline" could increase it by around 14 beats.
The study revealed that blood pressure could change by more than 10 millimeters of mercury depending on the type of drug, as "Nortriptyline" can lower the pressure by about 7 millimeters of mercury, while "Doxepin" raises it by about 5 millimeters.
Weight Gain
The researchers confirmed that some antidepressants such as "Maprotiline" and "Amitriptyline" were associated with weight gain in about half of the patients prescribed these drugs, while other medications like "Agomelatine" were linked to weight loss in 55% of the patients who took them.
These results clarified that the effects of psychiatric drugs are not limited to mood and neurological conditions but extend to physical balance and metabolism, making the choice of medication a decision requiring a high degree of precision and caution.
The study also indicated that most antidepressants did not show significant effects on kidney or liver functions, or on blood salt levels or heart rhythm regularity, providing doctors with a degree of reassurance when prescribing these medications.
However, the researchers noted that these results only reflect the short-term effects during the study period, as further research is still needed to determine whether these physical effects continue or change over time.
The findings call for an update to the therapeutic guidelines for prescribing antidepressants, considering the differences in physical effects between different medications, and that treatment decisions should be made individually in collaboration between the doctor and the patient.
The researchers pointed out that such an approach could improve treatment outcomes and reduce the side effects associated with generic or stereotypical prescriptions that do not consider each case’s specifics.
The researchers also noted that their study did not address other psychological and behavioral aspects of antidepressants, such as changes in sexual desire or emotional state, nor the differences in the effectiveness of the medications themselves, emphasizing that these aspects should be considered alongside the physical outcomes observed in the study.
Antidepressant Effects
They indicated that a comprehensive understanding of the effects of antidepressants requires integrating physical, psychological, and behavioral data within a single framework, to develop more balanced and fair treatment prescriptions for patients.
The analyses highlighted that the variation in the physical effects of antidepressants might stem from differences in how these drugs work within the brain. While some medications regulate "Serotonin" levels only, others interact with "Noradrenaline" or "Dopamine," differences that are also reflected in bodily reactions such as appetite and metabolic rate.
The researchers suggested that some changes in weight and blood pressure might be due to a direct effect on the autonomic nervous system, which is responsible for regulating vital body functions.
Despite this variation, the study authors emphasized that antidepressants remain among the most effective drugs for treating psychological disorders such as depression, general anxiety disorder, and post-traumatic stress disorder, and that the psychological benefits of these medications often outweigh the undesirable physical effects.
They affirmed that the goal of the study is not to warn against the use of these drugs, but to educate doctors and patients on the need to balance the benefits and potential risks, with monitoring the patient's physical condition during treatment.
The results focused on the fact that the "one-size-fits-all" approach is no longer appropriate in psychiatric medicine, especially as data now indicate a wide variance in drug responses.
They also called for the development of more accurate diagnostic tools that can predict how the body will react to antidepressants before starting treatment, to spare patients the painful trials of switching medications repeatedly before finding the right treatment.
The researchers alerted that the comprehensive analysis included in the research is one of the largest systematic reviews conducted on antidepressants to date, in terms of the number of studies and sample size involved, which lends significant statistical power to the findings.
They added that data extracted from reports from the U.S. Food and Drug Administration contributed to ensuring the accuracy and objectivity of the results, as it included information not previously published in scientific journals.
The research team considered this study an important step towards building a comprehensive understanding of the relationship between psychiatric medications and the body, as it is believed that the interaction of medication with different body systems could be key to understanding why some treatments succeed for certain patients and fail for others, pointing out that combining clinical studies with real-world observations from daily medical practices can provide a deeper insight into how to improve psychiatric treatment management in the future.
Sleep Patterns Change
The researchers observed that the differences in weight, blood pressure, and heart rate detected are not only cosmetic or physical discomforts but also have genuine health dimensions, particularly for patients suffering from chronic diseases such as diabetes, hypertension, or heart conditions.
They stressed that selecting the appropriate antidepressant for these patients must be done with extra care, with regular monitoring of their vital signs during the treatment period.
The study also indicated that the effect of antidepressants on weight could be related to factors such as increased appetite or changes in sleep patterns or disturbances in hormones associated with feelings of hunger and satiety.
It noted that some medications causing weight gain might be suitable in certain cases, like patients suffering from anorexia or weight loss associated with depression, while those causing weight loss are more suitable for those with increased body mass.
The researchers focused on the fact that treatment decisions should not be based on a single factor such as weight or blood pressure alone, but should consider the complete picture of the patient's mental and physical health.
They clarified that the treating physician is best equipped to determine the importance of each factor based on the individual case of each patient, with the necessity of involving the patient themselves in the decision-making process to strengthen their commitment to treatment and reduce the likelihood of early discontinuation of the medication.
The study called for long-term research tracking the effect of antidepressants over years, not just weeks, to understand whether these physical changes are temporary or accumulative, emphasizing that most clinical trials are limited to relatively short periods, making it difficult to observe slow or adaptive effects that may appear over time.
It also indicated that determining the relationship between the duration of use and the magnitude of physical changes can help doctors develop more flexible treatment plans, including specific monitoring periods to adjust dosages or change medications as needed. It noted that advances in medical data analysis techniques, including artificial intelligence, may soon provide a more accurate understanding of the physical impact patterns of each medication.
The researchers also emphasized the importance of continuous communication between doctors and patients during the treatment period, especially when noticing changes in weight, blood pressure, or heart rate. They advised that patients should be educated that some of these changes may be part of the body's natural adjustment to the medication, while others require precise medical follow-up.
The study authors saw the results as a motivating factor for the psychiatric medical community to adopt a more comprehensive concept in evaluating psychiatric medications, with a view to seeing the patient as a whole, not as a separate mood condition from their body, affirming that mental health cannot be separated from physical health, and any imbalance in one necessarily reflects on the other.
The study stressed that antidepressants remain vital therapeutic tools in the face of psychological disorders that are increasing globally, but they require smarter and more humane use, explaining that the path to personalized medicine in treating depression begins with understanding the subtle differences between medications, and from realizing that what suits one patient may not suit another.
The study called for the development of new treatment protocols that consider these individual differences to ensure that each patient receives the treatment that achieves the best psychological and physical balance with the fewest possible side effects.
