Antidepressant side effects vary critically from drug to drug - Careful consideration of individual patient wants and needs is now possible

By: Tom Cloyd - 4 minute read

(Published: 2025-10-21; reviewed: 2025-10-22:1526 Pacific Time (USA))

Page contents…

• Antidepressants affect the lives of millions of people ^
• The achievement of this recent review ^
• Practical results emerging from this study ^
• Limitations of the Pillinger, et al., study ^
• References ^
• Notes ^

Antidepressants affect the lives of millions of people ^{^}

Globally, it is estimated that about one person in seven takes antidepressant medication.¹ Treatment duration is typically 6 months to several years or longer, due to professional recommendations intended to reduce relapse and patient difficulties with discontinuation or fear of relapse.² Thus, changes in the effects of these medications, and in how they are used, potentially affect a significant proportion of the world’s population.

It is also critical to remember that overall the consequences of not using an antidepressant that works are typically far greater than any side effects it may cause.³ Depression can get quite serious, quickly.

The achievement of this recent review ^{^}

Pillinger and associates⁴ published today a side-by-side comparative analysis of short-term antidepressant side effects - something that has never before been with this degree of detail.³ Their review looked at “30 antidepressants, using data from more than 58,000 participants across 151 studies and 17 Food and Drug Administration reports”.³ They report that they confirmed that there is strong evidence that antidepressants vary widely in how they affect patients, especially with regard to metabolic and cardiovascular systems.⁴

While the most widely-prescribed antidepressants have generally mild side effects,³ associate researcher Oliver Howes explained⁵ that “there are big differences between antidepressants and this is important not just for individual patients, but large numbers of people are taking them, so even modest changes could have a big effect across the whole population.”

While it is a basic principle of medicine that people’s reactions to medication are individualized, some clear generalizations about side effects can be made. For example, some antidepressants typically cause weight gain, some weight loss. Some can cause sleepiness, while others may make sleeping more difficult.⁶

The desires of patients given these medications, relative to the side effects they want to avoid, are surely as variable as the side effects themselves can be, compared across drugs.

One patient might want to avoid weight gain, while another may worry about not increasing his high blood pressure, and another may be concerned about a possible elevation in blood cholesterol levels that can occur with some antidepressants.

The medication each individual is prescribed should reflect both their psychiatric needs and their whole-health and lifestyle needs. Without a summary table of the findings of this literature review, quickly matching patient to optimum medication can be challenging. Failure to achieve a truly good match can easily result in serious loss of quality of life, given the length of time these medications are often taken.⁵

Practical results emerging from this study ^{^}

Study researchers are developing a digital tool to assist health care professionals in better managing antidepressant prescription challenges. This tool is to be made available on the noteworthy Psymatik website. (The link takes on to a page on the site where a YouTube video shows how a similar tool on the website may be used to optimize prescription of schizophrenia medications - a truly challenging problem. The video moves quickly, but the animations in it give a good idea of how useful the tool can be. Using this tool should result in distinctly better care for patients.)

Limitations of the Pillinger, et al., study ^{^}

While the breadth and detail of this study⁴ is remarkable, there are a few things we should remember when using it in clinical practice or to assess one’s own medication:³

• the side effects that matter most are the ones that an individual patient has or does not have;
• the studies reviewed generally covered a period of time much shorter than that usually seen in most clinical applications;
• the range of side effects analyzed was not all-inclusive, as things like sexual malfunction or suicidal behavior were not considered.

References ^{^}

Bansal, N., Hudda, M., Payne, R. A., Smith, D. J., Kessler, D., & Wiles, N. (2022). Antidepressant use and risk of adverse outcomes: Population-based cohort study. BJPsych Open, 8(5), e164. https://doi.org/10.1192/bjo.2022.563

Gallagher. J. (2025, October 21). Effects of antidepressants on physical health ranked for first time. BBC.com. https://www.bbc.com/news/articles/c9d65nqgd5zo

Pillinger, T., Arumuham, A., McCutcheon, R. A., D’Ambrosio, E., Basdanis, G., Branco, M., Carr, R., Finelli, V., Furukawa, T. A., Gee, S., Heald, A., Jauhar, S., Ma, Z., Mancini, V., Moulton, C., Salanti, G., Taylor, D. M., Tomlinson, A., Young, A. H., … Cipriani, A. (2025-10-21). The effects of antidepressants on cardiometabolic and other physiological parameters: A systematic review and network meta-analysis. The Lancet, 0(0). https://doi.org/10.1016/S0140-6736(25)01293-0

Shakin, C. W. (2025, October 21). Antidepressant Side Effects Vary Widely by Drug, Study Finds. The New York Times. https://www.nytimes.com/2025/10/21/well/antidepressant-side effects.html

Starkman, E., & Ellis, R. R. (2025-03-12). What Are the Side Effects of Antidepressants? WebMD. Retrieved October 22, 2025, from https://www.webmd.com/depression/side effects-antidepressants

Statista. (2024, February 27). Consumption of antidepressants in selected countries in 2022 (in DDD per 1,000 inhabitants). Retrieved from https://www.statista.com/statistics/283072/ant.idepressant-consumption-in-selected-countries/

Notes ^{^}

 

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