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Exercise Benefits Mental Health Like Antidepressants – But Can Participants Keep It Up?

A woman poised to run at a racetrack.
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A study conducted at Vrije University, Amsterdam, has compared the effects of antidepressants and running on individuals experiencing anxiety and depression. The research, led by Professor Brenda Penninx, was presented at the European College of Neuropsychopharmacology’s annual conference.

The work has also been published in the Journal of Affective Disorders.

The research suggested that both interventions provided similar mental health benefits. Running was found to have additional benefits for physical health, which antidepressants lacked. Nevertheless, the running regimen had a poor adherence rate, suggesting that both treatment options have their pitfalls.

A choice of treatments

The study recruited 141 participants suffering from depression, anxiety or a combination of the two conditions. In an unusual trial format, the participants were given a choice of two interventions and were asked to choose between a 16-week course of an SSRI (selective serotonin reuptake inhibitor) antidepressant, escitalopram, or a group-format running therapy of the same duration. Given this option, over two-thirds of the cohort opted for the exercise-based treatment option.

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The running option had a target of completing two to three group running sessions a week, each lasting 45 minutes. But while 82% of the SSRI group successfully adhered to their dosing regime, nearly half of the running group (48%) failed to adhere to the prespecified protocol.

The two groups’ response to the interventions was measured by the percentage of participants who had entered remission – meaning that they no longer met the criteria for an anxiety or depression disorder as assessed by interview – or response – a 50% reduction in their symptom severity score – after 16 weeks of treatment. Among both groups, roughly 44% entered remission, while roughly a third showed a 50% symptom reduction. The running group differed from the antidepressant group by losing significantly more weight and showing improvements in their blood pressure. Several other physiological measurements, like triglyceride or cholesterol levels, did not vary between the groups.

Running up a hill or taking a pill?

Penninx reflected on the results by drawing attention to both treatment options’ limitations: “It is important to say that there is room for both therapies in care for depression. The study shows that lots of people like the idea of exercising, but it can be difficult to carry this through, even though the benefits are significant. We found that most people are compliant in taking antidepressants, whereas around half of the running group adhered to the two-times-a-week exercise therapy. Telling patients to go run is not enough. Changing physical activity behavior will require adequate supervision and encouragement as we did by implementing exercise therapy in a mental health care institution.”

Reference: Verhoeven JE, Han LKM, Lever-van Milligen BA, et al. Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. J. Affect. Disord. 2023;329:19-29. doi: 10.1016/j.jad.2023.02.064

This article is a rework of a press release issued by European College of Neuropsychopharmacology. Material has been edited for length and content.