Aerobic Exercise Lifts Depression in Treatment-Resistant Patients-----------------------------------------------------------------------------



WESTPORT, CT (Reuters Health) Apr 05 - A simple program of regular aerobic
exercise can substantially improve depression scores in patients with
moderate to severe major depression, despite prior failures with
pharmacologic therapy.

The new findings provide "grounds for cautious optimism" about the use of
exercise therapy as an alternative treatment for depression, Dr. F. Dimeo, of
the Benjamin Franklin Medical Center, in Berlin, Germany, and colleagues
conclude in the April issue of the British Journal of Sports Medicine.

The investigators studied the effects of aerobic exercise on depression in 12
patients with major depressive episodes ranging from 12 to 96 weeks in
duration. Of the patients, 10 were characterized as having refractory
depression after failing to improve during treatment with at least two
different classes of antidepressants for at least 4 weeks during the current
episode. The intervention consisted of interval training (walking speed) on a
treadmill for 30 minutes a day for 10 days.

Overall, exercise training caused a clinically significant drop in depression
scores during the 10 days. Of the twelve patients in the study, six
demonstrated "substantial" improvements — including five of the patients
with
refractory depression — two demonstrated slight improvements and four
remained unchanged.

Moreover, there was a high rate of acceptance of the intervention among the
group, Dr. Dimeo told Reuters Health. "Indeed, several patients asked to
continue the training program after the study was concluded."

The study director added that many questions remain about the role that
aerobic exercise should play in the treatment of depression. "Aerobic
exercise may certainly be used as complementary therapy in severely depressed
patients who receive antidepressants and do not have contraindications for
exercise. Since there is no evidence about the long-term effects of exercise
[and] compliance and outcomes when stopping training, aerobic exercise should
not be used as first-line therapy for depression until confirmatory studies
have been concluded."

Dr. Dimeo noted that the team has already initiated a larger, randomized
trial of aerobic exercise in depression. Preliminary results from this study,
he said, "are very promising."

Br J Sports Med 2001;35:114-117.