summary: Researchers offered 141 patients with anxiety and depression a choice between 16 weeks of SSRIs (antidepressants) or group running therapy, and found that both options had little to no effect on mental health. It has been shown that they provide similar benefits. However, despite the high dropout rate, significant improvements in physical health, including weight, waist circumference, and cardiovascular function, were observed in the running group.

There was a tendency for these metabolic markers to be slightly lower in the antidepressant group. This study highlights the importance and potential of exercise in mental health treatment, despite compliance challenges.

Important facts:

  1. Equal mental benefits, different physical results: Both running and SSRIs similarly reduced depression and anxiety, but unlike SSRIs, which tended to slightly impair metabolic markers, running also improved physical health.
  2. Adherence differences: Despite their initial preference for running, adherence was significantly lower (52%) than in the antidepressant group (82%), indicating that it is realistically difficult to maintain an exercise plan. I am.
  3. Patient preferences in treatment selection: This study reflected a pragmatic approach to mental health care, revealed participants’ initial preference for exercise, and offered patients a real choice between exercise and medication.

sauce: ECNP

The first study to compare the effects of antidepressants and running exercise on anxiety, depression, and general health shows that they have roughly the same effects on mental health, but running during the same period The 16-week course showed higher scores in terms of improvements in physical health. On the other hand, antidepressants make you feel slightly worse, as previous research has suggested. However, dropout rates were much higher in the group that chose exercise first.

Professor Brenda Penninx (Vrije Universiteit Amsterdam) presented this research at the ECNP conference in Barcelona (following a recent paper presentation) Affective Disorders Journal) say:

“We wanted to compare how exercise and antidepressants affect not just mental health, but general health.”

The running group was aimed at two to three 45-minute group sessions per week (over 16 weeks) with close supervision.Credit: Neuroscience News

Researchers studied 141 patients suffering from depression and anxiety. They were offered treatment options. 16 weeks of SSRI antidepressants or 16 weeks of group-based running therapy. 45 people chose antidepressants and 96 people took part in running.

Members of the group who chose antidepressants felt slightly more depressed than members of the group who chose running.

Professor Penninx said: “This study gives people with anxiety and depression a real choice between medication and exercise. Interestingly, the majority chose exercise, so there were more people in the running group than in the medication group. There have also been many.”

Treatment with antidepressants requires patients to strictly adhere to the prescribed dosage of the drug, which usually does not directly affect daily behavior.

In contrast, exercise can reduce the sedentary lifestyle common in patients with depression and anxiety disorders by encouraging people to get outside, set personal goals, improve physical fitness, and participate in group activities. directly address.

The antidepressant group took the SSRI escitalopram for 16 weeks. The running group aimed to have her 45-minute group sessions two to three times a week (over 16 weeks) with close supervision. Despite initially overusing antidepressants in favor of running, adherence to the protocol was lower in the running group (52%) than in the antidepressant group (82%).

At the end of the study, approximately 44% of both groups showed improvement in depression and anxiety, but the running group also saw improvements in weight, waist circumference, blood pressure, and heart function, whereas the antidepressant group A trend of improvement was seen. A slight decrease in these metabolic markers.

Brenda Penninx said:

“Both interventions improved depression to about the same extent. In general, antidepressants had negative effects on body weight, heart rate variability, and blood pressure, whereas running therapy improved depression, for example, on general health. This led to improved effects on heart rate. We are now looking more closely at the impact on biological aging and inflammatory processes.”

“It’s important to say that there is room for both treatments in the treatment of depression. This study shows that while many people like the idea of ​​exercising, even if its benefits are significant, It can be difficult to implement.

“We found that while most people were compliant with taking their antidepressants, about half of the running group were compliant with their twice-weekly exercise regimen. Telling patients to ‘run’ alone is not enough.

“Changes in physical activity behavior require appropriate supervision and encouragement, similar to the implementation of exercise therapy in a mental health facility.”

She added:

“Antidepressants are generally safe and effective. They work for most people. We know that not treating depression at all leads to worse outcomes. Therefore, antidepressants are generally safe and effective. Nevertheless, not all patients respond to or are willing to take antidepressants, so treatment options must be expanded.

“Our results suggest that the introduction of exercise therapy should be taken more seriously, as it may be a good, and perhaps even better, option for some patients. Masu.

“Also, let’s face the side effects that our treatments can cause. Doctors are worried that certain antidepressants can cause dysregulation of nervous system activity, especially in patients who already have heart disease. You need to be aware that there is a gender.

“This also provides grounds for serious consideration of reducing or discontinuing antidepressants once a depression or anxiety episode has gone into remission. After all, patients may be unnecessarily worsening their physical health. We can only truly help when we improve our mental health.”

This is based on a commentary recently published in a magazine. european neuropsychopharmacology2.

Dr. Eric Rouhe (University Medical Center Amsterdam) commented: “These are very interesting results that show once again that physical health can influence mental health and that it is possible to treat depression and anxiety with exercise, without the obvious side effects of antidepressants. It’s the result.” However, some caveats are important.

“It is common for patients to follow their own wishes first, but ideally patients should be advised what will be most effective. If a patient has strong preferences, it may be practical to follow this choice. This is understandable from a disciplinary perspective, but it must be taken into account when conducting such research.

“The downside is that comparisons between groups may be biased compared to doing this in a truly randomized study. For example, patients in the group given antidepressants were more depressed. , and this may be related to a lower likelihood of continued engagement with exercise. Therefore, although care must be taken not to overinterpret between-group comparisons, the authors also is properly acknowledged.

“Finally, a very important finding was the difference in adherence between the interventions: 52% in the exercise group and 82% in the antidepressant group. It also shows that it is difficult.

“This is not just something we see in psychiatry, but shows that we must also focus on ways to improve adherence to healthy behaviors. It can also have a huge impact on disease.”

About this exercise, psychopharmacology, and depression research news

author: tom parkhill
sauce: ECNP
contact: Tom Parkhill – ECNP
image: Image credited to Neuroscience News

Original research: The results of this study will be presented at the 36th European Society of Neuropsychopharmacology (ECNP) Congress.



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