Researchers have discovered that exercise can be as effective as a second medication for individuals who were not helped by treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant medication.
UT Southwestern Medical Center scientists discovered that as many as 50 percent of people taking a second medication for depression can reduce the medication burden by substituting a prescribed exercise program.
The report is published in the Journal of Clinical Psychiatry.
Researchers found that both moderate and intense levels of daily exercise can work as well as administering a second antidepressant drug, which is often used when initial medications don’t move patients to remission.
The type of exercise needed, however, depends on the characteristics of patients, including their gender.
This important finding is the result of a four-year study conducted by UT Southwestern’s psychiatry department in conjunction with the Cooper Institute in Dallas.
The study, begun in 2003, is one of the first controlled investigations in the U.S. to suggest that adding a regular exercise routine, combined with targeted medications, actually can relieve fully the symptoms of major depressive disorder.
“Many people who start on an antidepressant medication feel better after they begin treatment, but they still don’t feel completely well or as good as they did before they became depressed,” said Dr. Madhukar Trivedi, the study’s lead author.
“This study shows that exercise can be as effective as adding another medication. Many people would rather use exercise than add another drug, particularly as exercise has a proven positive effect on a person’s overall health and well-being.”
Researchers evaluated participants diagnosed with depression whose symptoms had not resolved with treatment using a SSRI. Participants ranged in age from 18 to 70.
Subjects were divided into two groups with each group receiving a different level of exercise intensity for 12 weeks. Sessions were supervised by trained staff at the Cooper Institute and augmented by home-based sessions.
Participants – whose average depression length was seven years – exercised on treadmills, cycle ergometers or both, kept an online diary of frequency and length of sessions, and wore a heart-rate monitor while exercising at home. They also met with a psychiatrist during the study.
By the end of the investigation, almost 30 percent of patients in both groups achieved full remission from their depression, and another 20 percent significant displayed improvement, based on standardized psychiatric measurements.
The intensity of the exercise session were important for women. Among women with a family history of mental illness, moderate excise was more effective. However, for women whose families did not have a history of the disease, intense exercise was nominal.
Among men, intense or higher rates of exercise were more effective regardless of other characteristics.
“This is an important result in that we found that the type of exercise that is needed depends on specific characteristics of the patient, illustrating that treatments may need to be tailored to the individual,” said Trivedi.
“It also points to a new direction in trying to determine factors that tell us which treatment may be the most effective.”
Source: UT Southwestern Medical Center