Clinical Tool
Antidepressant Metabolic Guide
Medication education for patient-provider discussions.
Based on a 2025 Lancet systematic review and network meta-analysis.
How to read this tool
- Numbers are trial averages, not predictions for one person.
- The source analysis included 30 antidepressants; this tool highlights 17 commonly discussed agents.
- Median treatment duration in the analysis was 8 weeks, so long-term effects may differ.
- Confidence intervals matter. A neutral average does not mean no individual side effects.
- This is not a medication-switching tool or a substitute for clinical care.
Source frame
What the analysis reviewed
Pillinger and colleagues reviewed antidepressant effects on weight, cardiovascular, metabolic, and other physiological parameters in a 2025 systematic review and network meta-analysis in The Lancet. The public tool uses selected summary values as medication-discussion prompts, not individual predictions.
Class-level read before selecting a medication
These are broad patterns from trial averages. A prescriber still has to weigh diagnosis, response history, interactions, blood pressure, sleep, weight, liver history, and patient preference.
| Class | Examples in this tool | What to watch |
|---|---|---|
| SSRIs | Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline | Often weight-neutral in acute trials; individual appetite, sleep, sexual side effects, and liver signals still vary. |
| SNRIs | Desvenlafaxine, duloxetine, levomilnacipran, venlafaxine | Blood pressure, cholesterol, glucose, and liver-enzyme monitoring may matter depending on the agent and history. |
| Tricyclics / tetracyclics | Amitriptyline, nortriptyline, maprotiline | Weight, heart rate, blood pressure, sedation, anticholinergic burden, and overdose safety need explicit discussion. |
| Atypical / multimodal | Agomelatine, bupropion, mirtazapine, vortioxetine | Profiles differ sharply by medication; weight, sleep, appetite, liver history, anxiety activation, and indication matter. |
Select a medication above
Choose an antidepressant to view its metabolic profile and monitoring discussion points.