Exercise has been proven as an effective treatment for major depressive disorder (MDD), and now there is sufficient research to help doctors prescribe the proper dose of exercise for depressed patients, according to a new report in the Journal of Psychiatric Practice.
“Despite the substantial evidence supporting the use of exercise in the treatment of MDD, previous studies have not provided a clear indication of the proper dose of exercise needed to elicit an antidepressant effect,” said Chad Rethorst, PhD, and Madhukar Trivedi, MD, of the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas.
To fill this gap, the researchers looked at available data taken from randomized controlled trials, with the goal of developing detailed recommendations for clinicians on how to prescribe exercise for their patients with clinical depression.
Based on research, aerobic exercise is the preferred form of exercise for patients with major depression. There is also some research support for resistance training, said Rethorst and Trivedi.
Researchers suggest that patients participate in three to five exercise sessions per week, for 45 to 60 minutes per session. In terms of intensity, for aerobic exercise, they recommend achieving a heart rate that is 50 to 85 percent of the individual’s maximum heart rate.
For resistance training, they recommend a variety of upper and lower body exercises — three sets of eight repetitions at 80 percent of the maximum weight that the person can lift one time.
The findings suggest that patients may experience a relief in depression in as little as four weeks after starting exercise. However, Rethorst and Trivedi emphasize that the exercise regimen should be continued for at least 10 to 12 weeks to achieve the greatest antidepressant effect.
Although some people question whether patients with MDD would actually participate in an exercise program, the studies reveal that only about 15 percent of patients dropped out of the exercise programs — comparable to dropout rates in studies of medications and psychotherapy.
The researchers suggest strategies that may help improve adherence to exercise programs, such as consulting patients about their favorite type of exercise and giving out individualized educational materials and feedback.
“Taken as a whole, these findings suggest that exercise doses below the current recommendations may still be beneficial for patients with MDD,” said Rethorst and Trivedi.
“Therefore, clinicians should encourage patients to engage in at least some exercise, even if they do not exercise enough to meet current public health recommendations.”
Source: Wolters Kluwer Health