Breaking Research on Antidepressants and Chronic Illness

Hi Friend

I want to draw your attention to the recent headline from King’s College London and University of Oxford — because given what you’re managing with Fibromyalgia, ME, hEDS or long covid, the findings are highly relevant.

🔍 The study: what they found

The research analysed data from 151 clinical trials, with more than 58,000 people, covering around 30 commonly used antidepressants.
Here are some of the key findings:

• Weight change ranged significantly: for example, users of Agomelatine averaged a 2.5 kg weight loss in ~8 weeks, whereas users of Maprotiline had an average 2 kg weight gain in the same period.

• Heart-rate change differences of up to ~21 beats per minute were observed: for example between Fluvoxamine (which reduced heart rate) and Nortriptyline (which increased heart rate).

• Blood-pressure variation: there was an up to 11 mmHg difference in some pairwise comparisons — for instance between Nortriptyline and Doxepin.

• The class of antidepressants known as SSRIs (selective serotonin re-uptake inhibitors, e.g., Sertraline, Citalopram) tended to have fewer of these physical side-effects than older classes like tricyclics (e.g., Amitriptyline) or certain SNRIs.

• The authors emphasise that this variation in physical effects is not trivial, and suggest treatment guidelines should more explicitly account for these side-effect profiles.

⚠️ Why this is critical for you (with fibromyalgia/ME/CFS/long COVID)

Because when you’re dealing with a condition like fibromyalgia, your system is already dealing with: nervous-system dysregulation, autonomic instability, heightened sensory sensitisation, and often metabolic or inflammatory stress. By adding a medication whose “physical load” (weight, heart rate, blood pressure) shifts significantly, you may unintentionally destabilise that fragile system.
Here are some more specific ways this plays out:

• A 2 kg+ weight gain in 8 weeks may mean increased load on joints, increased pro-inflammatory signalling, and reduced movement capacity (which for someone with fibromyalgia is already a sensitive threshold).

• A 20-beat/min change in heart rate (or an ~11 mmHg rise in blood pressure) may translate into increased sympathetic drive, reduced HRV (heart-rate variability), and more frequent flare risk.

• If you were prescribed a drug primarily for “mood/pain/sleep” but it shifts your physical baseline (e.g., increases HR, BP, weight), you may not feel the benefit in the way you expect — or you may see unwanted knock-on effects (more fatigue, increased pain, reduced resilience).

• The fact that SSRIs had fewer physical side-effects is useful information — but “fewer” doesn’t mean “none” and every individual’s response will differ greatly (especially when chronic illness is present).

✅ What you can do (right now)

• If you are on any antidepressant, ask your clinician about not only mood/psychology outcomes, but also physical baseline monitoring: weight, resting heart rate/HRV, blood pressure.

• Log your own multi-system “baseline” for a few weeks: energy levels, pain severity, sleep quality, movement tolerance, any symptom flares. Then track again 4–8 weeks after any change in medication (dose or new drug).

• If a medication is helping mood/pain but you see deterioration in physical markers (e.g., increased heart rate, reduced HRV, weight gain, more flares), you don’t necessarily need to stop it — but you do need to weigh the trade-offs and perhaps demand closer monitoring or a combined approach (med + regulation + lifestyle) rather than med alone.

• Recognise that medication is a tool, not a standalone solution, especially for conditions characterised by nervous-system dysregulation. That means prioritising nervous-system stabilisation, pacing, nutrition, movement adaptation, and emotional/trauma work alongside any pharmacotherapy.

🌱 How The Mend Collective supports you

Here’s how our programme is designed to integrate (not compete with) your clinical care and medications — and give you the broader system support you need:

• It begins with a self guided video assessment that maps your symptoms, fatigue patterns, movement tolerance and flare triggers — giving your entry a strong foundation of data and context.

• You receive a 16-week personalised roadmap that builds around your current capacity and recovery stage, with modules in nervous-system regulation, gentle movement, nutrition and therapeutic practice (so that you’re not relying only on medication for ‘fixing’ things).

• You have access to a community and live sessions (sound therapy, somatic work, pacing workshops) designed for people who live with fluctuating systems — helping you build resilience, capacity and stability rather than pushing through.

• Importantly: we emphasise tracking your system, not just your symptoms or mood. So you’ll learn to monitor how movement, sleep, nutrition, stress and even medications affect your system as a whole — enabling you to have more informed conversations with your clinician or prescribe team.

We are launching in 4 days on 30/10/25, if you haven’t already you can join the waitlist here:

If you’re using antidepressants (or thinking about them) and you live with a chronic condition, this research is a signal: yes, meds can help, but they are part of a broader picture — especially when your nervous system is already vulnerable.

I will be sending more practical tools this week — including a worksheet to log your baseline physical markers, and a short video on nervous-system calming techniques to pair with your next care step.

Warmly,
Dr Ahmed
The Mend Collective