Exercise for depression

Dr. Weeks’ Comment: The best answer to any and all health challenges is rarely in a pill; lifestyle is the path to cure. Here we see (again) that exercise is superior to antidepressant medications.



Journal of Affective Disorders

Volume 329, 15 May 2023, Pages 19-29

Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders

https://doi.org/10.1016/j.jad.2023.02.064Get rights and content


  • 141 patients with depression and/or anxiety disorder participated in this study.
  • Running therapy and antidepressant medication had similar effects on mental health (remission and response rates).
  • Running therapy outperformed antidepressant medication on physical health variables.
  • Running therapy is a valuable treatment strategy in mental health care.



Antidepressant medication and running therapy are both effective treatments for patients with depressive and anxiety disorders. However, they may work through different pathophysiological mechanisms and could differ in their impact on physical health. This study examined effects of antidepressants versus running therapy on both mental and physical health.


According to a partially randomized patient preference design, 141 patients with depression and/or anxiety disorder were randomized or offered preferred 16-week treatment: antidepressant medication (escitalopram or sertraline) or group-based running therapy ≥2 per week. Baseline (T0) and post-treatment assessment at week 16 (T16) included mental (diagnosis status and symptom severity) and physical health indicators (metabolic and immune indicators, heart rate (variability), weight, lung function, hand grip strength, fitness).


Of the 141 participants (mean age 38.2 years; 58.2 % female), 45 participants received antidepressant medication and 96 underwent running therapy. Intention-to-treat analyses showed that remission rates at T16 were comparable (antidepressants: 44.8 %; running: 43.3 %; p = .881). However, the groups differed significantly on various changes in physical health: weight (d = 0.57; p = .001), waist circumference (d = 0.44; p = .011), systolic (d = 0.45; p = .011) and diastolic (d = 0.53; p = .002) blood pressure, heart rate (d = 0.36; p = .033) and heart rate variability (d = 0.48; p = .006).


A minority of the participants was willing to be randomized; the running therapy was larger due to greater preference for this intervention.


While the interventions had comparable effects on mental health, running therapy outperformed antidepressants on physical health, due to both larger improvements in the running therapy group as well as larger deterioration in the antidepressant group.

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