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Researchers from King's College London and the University of Oxford have ranked different antidepressants based on their physical side-effects in a first study of its kind.

The research, published in The Lancet, examined 151 studies and 17 US Food and Drug Administration reports involving 58,534 patients and compared 30 antidepressants with a placebo.

The study looked at the effects the drugs had on patients eight weeks after they started taking them and found antidepressants resulted in “clinically significant differences” in weight loss, heart rate and systolic blood pressure.

They found an almost 4kg difference in the change in weight between agomelatine and maprotiline. The former was linked to a 2.4kg reduction in weight, the latter a 1.82kg increase.

“We found little evidence of change in weight with phenelzine, desipramine, vilazodone, escitalopram, vortioxetine, reboxetine, imipramine and clomipramine,” the researchers said.

Fluvoxamine was linked to a slower heart rate with eight less beats a minute compared with nortriptyline which showed 13 more beats.

Researchers also found an 11mmHg difference in blood pressure between nortriptyline and doxepin, the former linked to a 6.68mmHg decrease, the latter a 4.94mmHg increase.

Reboxetine was linked to a 0.14mmol/L drop in cholesterol compared with desvenlafaxine which was linked to a 0.27mmol/L increase, while imipramine was linked to a 0.21mmol/L drop in glucose compared with duloxetine which showed a 0.30mmol/L increase.

“We did not find strong evidence of any antidepressant affecting levels of potassium, urea, and creatinine to a clinically significant extent,” the researchers said.

Empower individuals to engage in shared decision-making with GPs

The study implied that giving people the ability to choose what antidepressant to take based on their own preferences and health conditions might be the best way forward.

“Treatment guidelines should be updated to reflect differences in physiological risk but choice of antidepressant should be made on an individual basis, considering clinical presentation and preferences of patients, carers, and clinicians,” the study said.

One of the researchers, Dr Toby Pillinger, told BBC Radio 4's Today programme the “last thing” the study was designed to do was “to be scaring people”.

“I want to see this as empowering individuals to take the initiative and to engage in shared decision-making with their practitioner,” he said.

Conceding the research had limitations, he added: “The majority of the studies we looked at were relatively short. We're looking at eight weeks' duration and still within that duration, we were seeing large changes in physical health parameters which we would argue have clinical relevance.”

The research was funded by the National Institute for Health Research, Maudsley Charity, Wellcome Trust and the Medical Research Council.