In a recent study published in the Journal of Affective Disorders, a team of Dutch researchers compared the effects of antidepressants and exercise therapy in the form of group running on the physical and mental health of people with anxiety and depression.
Study: Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. Image credit: Jacob Lund/Shutterstock
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There is growing evidence that anxiety and depression can affect not only mental health, but also physical health, including immunity, strength and cardiac health. After psychotherapy, antidepressants are considered the most effective and well-tolerated treatment option. However, patients vary in their response to antidepressants and the severity of their side effects.
Exercise therapy has been promoted as an alternative treatment for anxiety and depression. For mild to moderate depression, research has shown that exercise therapy is as effective as psychotherapy and antidepressants. Additionally, for severe depression, exercise therapy continues to be useful as a complementary therapy. There is less research on the effects of exercise therapy on anxiety than there is on depression, but current findings are promising.
Although the effects of exercise therapy and antidepressants on mental health outcomes in patients with anxiety and depression are similar, the impact of both treatments on patients' physical health may differ, given the different underlying pathophysiological mechanisms.
About the Research
In this study, the researchers conducted a 16-week intervention study to examine how antidepressants and group running therapy affect the mental and physical health of people with anxiety and depression.
The study investigated mental health outcomes such as diagnostic status and symptom severity, while physical health outcomes included measures of immune and metabolic health, heart rate variability, lung function, weight, physical fitness, and grip strength. The researchers hypothesized that mental health outcomes would not differ significantly between the two interventions, but that outcomes related to physical health would differ.
Participants were eligible for the study if they were between the ages of 18 and 70 and currently diagnosed with major depressive disorder or an anxiety disorder, such as panic disorder, generalized anxiety disorder, agoraphobia, or social phobia. People who had used antidepressants in the past two weeks, exercised regularly, were at acute suicide risk, were pregnant, or had contraindications to any of the two interventions were excluded.
Escitalopram, a selective serotonin reuptake inhibitor with few side effects and high efficacy, was the antidepressant used in one of the two interventions. Administration logs and patient diaries were used to determine adherence to the intervention.
The other intervention involved 45 minutes of supervised outdoor running two to three times each week for 16 weeks. All participants who underwent this intervention wore heart rate monitors to help check their adherence to the exercise regimen.
Participants' fasting blood glucose samples were used to assess glucose, triglyceride, and high-density lipoprotein cholesterol levels. Serum levels of interleukin-6, interferon-gamma, tumor necrosis factor-alpha, and C-reactive protein were also measured. A range of other tests were used to assess autonomic nervous system activity, fitness level, and lung function.
result
The study found that while mental health outcomes from the two interventions were comparable, running therapy had a significantly more positive impact on physical health outcomes than antidepressants.
Physical health characteristics such as weight, waist circumference, heart rate, heart rate variability, and blood pressure were significantly different between the two interventions. The running therapy group showed greater improvements in all of these factors than the antidepressant-treated group. C-reactive protein and triglyceride levels were also found to differ between the running therapy and antidepressant interventions.
The results also showed that the type of intervention did not affect treatment effects, with the difference in outcomes being the same whether participants were randomized or chose their intervention according to their preferences. However, adherence to the treatments differed significantly, with higher adherence to antidepressants (82%) than to running therapy (52%). The researchers consider this finding important as it could have major implications for treatment recommendations and prescriptions for anxiety and depression.
Conclusion
Overall, the findings showed that while the rates of remission of anxiety and depression with running therapy and antidepressants were similar, physical health outcomes differed significantly between the two interventions.
Antidepressant treatment increased blood pressure, waist circumference, and triglycerides, and decreased heart rate variability, indicating an increased risk of metabolic syndrome. In contrast, running therapy improved all metabolic and cardiovascular indices. These results highlight the importance of incorporating exercise as a standard method of treatment for anxiety and depression.
Journal References:
Verhoeven, JE, Han, LKM, Bianca, Hu, MX, Révész, D., Hoogendoorn, AW, Batelaan, Neeltje M, Schaik, van, Balkom, van, Oppen, van, & Penninx, BWJH (2023). Antidepressants or running therapy: Comparison of effects on mental and physical health in patients with depression and anxiety disorders. Journal of Affective Disorders, 329, 19-29. 10.1016/j.jad.2023.02.064, https://www.sciencedirect.com/science/article/pii/S0165032723002239
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