It is too simplistic to say there are good and bad antidepressants, the researchers say. Even though amitriptyline increases weight, heart rate and blood pressure it also helps with pain and struggling to sleep.
Overall, the most prescribed class of antidepressants – SSRIs such as paroxetine, citalopram, escitalopram and sertraline – tended to have fewer physical side effects.
Fluoxetine – an SSRI that is also called Prozac – was linked to a drop in weight and higher blood pressure, in the study.
Prof Andrea Cipriani from the University of Oxford said it was “impossible” to say how many of the millions of people being prescribed antidepressants should be on a different drug.
However, he said there had been a push for “generic, cheap medications” that meant 85% of antidepressant prescriptions in the UK were for just three drugs: the SSRIs citalopram, sertraline and fluoxetine.
He said implementing the findings of this report would see “the 85% reduce dramatically” with “more people accessing better treatments”.
The researchers are developing a free online tool, external to help doctors and patients choose the right drug.
However, that would still require a significant change in culture within the NHS.
The study also only analysed what happened eight weeks after starting treatment. Dr Pillinger said “complimentary data” meant they expected the short-term changes “will persist” but this still needs to be properly tested.
Dr Prasad Nishtala, from the University of Bath which was not involved in the study, said the findings were “novel and valuable”.
He said: “In a real-world setting, where patients often receive antidepressants for months or years, the cumulative risks are likely to be higher, particularly among those with chronic depression.”
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