October 23, 2025
Thom Carroll/For PhillyVoice
The findings of a large new study should guide the prescription of antidepressants, especially for people with diabetes, obesity hypertension, the researchers behind it say
Weighing the benefits of antidepressants against the costs of their potential side effects can be tricky for the millions of Americans who take these prescription drugs.
But a large new study examining the impact of 30 antidepressants on weight, blood pressure and heart rate should help guide future prescribing practices, the researchers said.
The research, published Tuesday in The Lancet, was the most "comprehensive and carefully done" meta-analysis of these drugs' side effects, Dr. Andrew J. Gerber, a psychiatrist and the president and medical director of Silver Hill Hospital in New Canaan, Connecticut, told The New York Times. Gerber was not involved in the research.
More than 15 million adults in the United States take antidepressants for depression or anxiety. The prescribing of antidepressants to young people jumped during the pandemic.
For the study, researchers from King's College London examined data about 30 antidepressants from 151 randomized trials involving 58,534 people. The trials all tracked the effects of the medications on weight, blood pressure and heart rate.
People taking the selective serotonin reuptake inhibitors like fluoxetine, sold under the brand name Prozac, and sertraline, sold under the brand name Zoloft, experienced weight loss. So did people taking bupropion, sold under the brand name Wellbutrin. People on the less-common mirtazapine, with the brand name Remeron, had weight gain.
Fluoxetine also had an association with elevated blood pressure. Venlafaxine was linked with increases in heart rate, while paroxetine (Paxil) was not.
Paroxetine and the serotonin-norepinephrine reuptake inhibitors venlafaxine (Effexor) and duloxetine (Cymbalta) were all associated with higher total cholesterol. Duloxetine was linked to higher blood sugar levels.
"For years, debates about antidepressants have been framed as 'do they work?' or 'are side-effects real?'" the researchers wrote. "Our findings suggest a more useful question: which drug suits which person, given their physical health and priorities?"
Gerber told the New York Times that the "health risks of untreated depression are far larger than any of the health risks associated with the treatments themselves."
No one should discontinue their antidepressant based on the findings of this study, but instead talk with their health care provider before making any changes, researchers said.
The researchers included only short-term trials of about eight weeks in their meta-analysis. Also, the researchers did not examine other side effects commonly associated with antidepressants, such as nausea, headache and sex drive.
