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[CLKD]

Side effects of different antidepressants have been ranked for the first time, revealing huge differences between drugs.

Academics looked at the impact medications had on patients in the first eight weeks after starting treatment, with some causing patients to gain up to 2kg in weight or vary heart rate by as much as 21 beats every minute.

Around eight million people in the UK take antidepressants.

Researchers warned the gulf in side effects could affect people's health and whether they could stick to their prescription.

They said nobody reading this should stop their treatment, but have called for antidepressants to be closely matched to the needs of each person.
"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," said researcher Prof Oliver Howes.

We've always known antidepressants affect physical health. The study by King's College London and the University of Oxford is the first to produce a ranking so the effects of medicines can be easily compared.

The team analysed 151 studies of 30 drugs commonly used in depression, involving more than 58,500 patients.

Not everybody develops side effects but, on average, the results published in the Lancet medical journal, external showed: ........

[CLKD]

Some patients may gain weight: I wonder whether the report checks their weight for 3-6 months prior to being prescribed ADs?  Because many sufferers find it difficult to eat so being less depressed may encourage proper habits.

"We've" - we, who exactly?  My biggest problem was intense nausea within 24 hours of the 1st five ADs that were prescribed.  Even Prozac, new to the market then. 

151 studies: ?? which 30 drugs commonly used ??  how were these studies obtained and from whom, how long ago was this research carried out?

So many questions. 

I would suspect that GPs will be matching to the potential needs of each patient ........ until a satisfactory regime is found to be of benefit.  This does depend of course on the honesty of the patient when describing symptoms which is why it is important to take a list of concerns to discuss.  When very depressed I could hardly move and was totally unable to express myself, so deep was the dark tunnel.  So DH came with me ........  . 

[sheila99]

I suspect GPS prescribe initially based solely on cost and only change if there are problems with it.

[CLKD]

That may be true in some cases, I've been able to work with our medics successfully.

[Minusminnie]

I suspect GPS prescribe initially based solely on cost and only change if there are problems with it.

And give out the one that is popular at the time.

Sertraline is on my radar not suitable for everyone.
A GP readily gave this to my daughter when the contraindication should have been noted.

[Aprilflower]

I suspect GPS prescribe initially based solely on cost and only change if there are problems with it.

And give out the one that is popular at the time.

Sertraline is on my radar not suitable for everyone.
A GP readily gave this to my daughter when the contraindication should have been noted.

Absolutely.

One tablet of that sent me  into the worst anxiety episode I ever had.  It's on medical record now, that I'm allergic to it. :

[CLKD]

My friend reacts to Propranolol, sends him wild and agitated. 

All the leaflets in the boxes seem to be the same.

[bombsh3ll]

I don't think this is new information, but it is good that it is being recognised that that this medication class causes unwanted effects in a significant proportion of people.

For too long I believe antidepressants have been perceived as safe for all and prescribed like candy, often for vague indications or in place of appropriate assessment and treatment of a condition that would benefit more from targeted intervention such as menopause or PMDD.

I don't think this should scare anyone, but I do think it should give pause to both clinicians and potential patients to weigh up the value of taking an antidepressant against the possible downsides.

Another thing that has always concerned me is people being started on antidepressants which are then continued on repeat prescriptions with little or no clinical follow up, some of them for years, with no exit strategy and objectively little benefit from treatment.

[CLKD]

For me ADs were life savers.  My GP has followed my treatment regimes closely, B4 the government of the day insisted on targets 2 B met, every few days when necessary. 

The Law is now that every patient receives an annual medication assessment.  Our Pharmacist linked to our surgery phones me during my birth month, that's so patients don't forget to make the appt  .  Checks how I am feeling, which meds I still require ........... and really, patients need to take responsibility for making sure that they still require their meds..  Once I felt well and less likely to jump under a train, and my meds were on repeat - hence the requirement for the annual assessment as well as not being able to collect within a certain number of days: 4 me it's every 4 weeks - I was able to recover slowly.  DH and I now have a Life together.

A few years ago my GP asked what I would do should he suggest stopping my medication: "After all the work that U have done to keep me alive ........ " he was apparently ticking boxes for the government.  It's never been muted again.

Having said that, I get an annual blood test as I take statins: DH doesn't  probably because he isn't on the radar.

[getting_old]

I suspect GPS prescribe initially based solely on cost and only change if there are problems with it.

And give out the one that is popular at the time.

Sertraline is on my radar not suitable for everyone.
A GP readily gave this to my daughter when the contraindication should have been noted.

Not ADs but the last time a doctor prescribed me medication they selected it via a Google search   

[CLKD]

Is that a problem?  Years ago they flipped through an MIMS booklet!  What was the GP accessing, did U think 2 ask?

Not many of us would think 2 query either, in the 8 years I was a medical secretary not 1 patient asked what 'routine blood tests' meant 

[common-lime]

I've had mental health problems severe enough to end in hospitalisations in my 20s. I've always reacted very weirdly to antidepressants - they tend to make me agitated, hypomanic and/or suicidal. I've had a host of physical side effects too, from the more common digestive issues to urinary retention and the clear winner, an allergy to sunlight. Other psych meds have similar contrary effects, like agitation on mood stabilisers, panic attacks on betablockers (due to sudden drops in blood pressure), insomnia on zopiclone and sleep paralysis on diazepam. So I swore off them all 15 years ago and had to try to keep myself alive in other ways. Luckily I was successful.

I think the NHS mental health services would have continued changing or adding meds indefinitely if I hadn't dropped off their radar on purpose. I've seen this with my dad, who can't get away so easily. He had a life changing stroke in January, and was put on an SSRI two weeks later when he was quite understandably upset and in shock. He became more emotionally unstable after initiation and psychotic when they increased the dose a month or two later, with no indication of a further stroke. He's not recovered and the doctors won't take our family history seriously - my youngest sister also hallucinated after a couple of weeks on one SSRI and ended up in A&E, and I suspect we tend more towards the bipolar side of the mood disorder spectrum. But the answer to bad reactions to SSRIs seems to be disbelief and an increase in dose.

They save peoples lives but they also ruin others. I'm glad of any research which might make prescribers think a bit more beforehand and monitor more carefully during.

[CLKD]

common-lime - this is dreadful for you all!  Ativan made my Dad agitated, we would walk miles together, not speaking.  It's used as a pre-med successfully for most.

Sometimes the brain chemistry reacts in ways not expected.  Has any1 suggested to you why this might be?  Initially I tried to find out causation of my depression but no-one was interested - I felt a Thesis for some1 would be in order  .

Were your episodes cyclical?  Dr Kath Dalton did a lot of research regarding 'time of the month' when Girls/women became a danger to themselves and/or others.  She represented several in Court.  I was advised by The National Association of Pre-menstrual Syndrome to eat every 3 hours, 24/7 which worked for me to stop those sudden energy dips = anxiety and panic.

Is your Dad still taking the AD?

[common-lime]

CLKD - yes, my dad is still on the SSRI despite several of the family raising it as a concern. He was doing well physically in rehab, got more emotionally labile leading up to discharge so they increased the dose, and he's been completely away with the fairies ever since, had to be discharged to a care home and back to square one in terms of mobility and continence. There was such a clear starting point it could only be the meds or another stroke, but his scans have shown no difference from the original series he had after the first stroke. I can't fathom why they won't even try dialling down the meds, but having worked in a care home some time ago I know it's common to fling meds at residents for convenience sake. He's only 68, it's a bit young to be throwing someone on the scrap heap. It's infuriating. I'm 400 miles away too so there's a limit to what I can actually do.

My own mental health was never tied to my cycle. I tracked symptoms for years and my brain just seemed to do stuff for no reason 😂 I'm very analytical and wasn't a fan of not being able to find the triggers. There must have been reasons, but they weren't linked to anything I could track like my periods, diet and exercise, seasons, external circumstances, etc. Probably more of a genetic vulnerability that reached repeated tipping points with lots of contributing factors. There has to be some biological mechanisms involved given that my relatives are also incredibly weird on antidepressants!

Wouldn't it make such a difference if the NHS had the resources to be more curious about individual variation in mental illness? I work in healthcare myself now and frequently come across people who are on ill suited regimes - a young person with a family history of hypothyroid who has all the symptoms themselves but has been put on an SSRI with not so much as a blood test, adults who are neurodivergent or incredibly traumatised but only have depression and anxiety diagnoses, a woman in her late 40s recently who had developed disabling panic attacks after starting an SSRI for initially mild anxiety - her GP kept trying to increase her dose, which had a catastrophic impact every time, but hadn't mentioned peri as a possibility. She was off the SSRI, on HRT and 95% better by the time last time I caught up with her. If we just thought about cause a little more it could make a lot of difference. There would still be oddities like me who are ill for reasons we can't yet discern, but some of this stuff is really low hanging fruit.

[CLKD]

It's the not knowing that is so difficult.

Many years ago [1960s] my Dad was under the care of Dr Sergeant in London who used deep sleep therapy as well as ECT for depression ......... all this experiment has now been discouraged ..... there is a book which I have on my shelf, yet to read. 

My maternal Gran had post natal depression so was 'shut away' .......... now we know better. 

Does your Dad have a Care Plan overseen by a GP Surgery?  Legally a Home has to engage the local Practice to cover residents, being 400 miles away is difficult.  We are 2 hours from where Mum lives, who no longer can be bothered to see us so we don't go.