Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder

Datos Bibliográficos

ID19301397
AutoresJames A Blumenthal (0000-0003-3789-0935, Duke Medical Center, autor de correspondencia), Michael A Babyak, P Murali Doraiswamy (0000-0003-0697-3893), Lana L Watkins (0000-0003-1889-5730), Lana Watkins, Benson M Hoffman, Krista A Barbour, Steve Herman, W Edward Craighead (0000-0001-9957-0027), Alisha L Brosse, Robert Waugh (0009-0002-9629-0585), Alan Hinderliter, Alan L Hinderliter (0000-0002-3262-5668), Andrew Sherwood (0000-0001-9067-185X)
Año2007
Volumen69
Número7
Páginas587-596
Fecha de publicación2007-09-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaPsychosomatic Medicine (JOURNAL)
Identificadores de la revistaISSN: 0033-3174 • E-ISSN: 1534-7796
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0b013e318148c19a
PMID17846259
PMCIDPMC2702700
OpenAlexW2154166294
IdiomaEN
Citas recibidas62
Referencias citadas54

OBJECTIVE: To assess whether patients receiving aerobic exercise training performed either at home or in a supervised group setting achieve reductions in depression comparable to standard antidepressant medication (sertraline) and greater reductions in depression compared to placebo controls. METHODS: Between October 2000 and November 2005, we performed a prospective, randomized controlled trial (SMILE study) with allocation concealment and blinded outcome assessment in a tertiary care teaching hospital. A total of 202 adults (153 women; 49 men) diagnosed with major depression were assigned randomly to one of four conditions: supervised exercise in a group setting; home-based exercise; antidepressant medication (sertraline, 50-200 mg daily); or placebo pill for 16 weeks. Patients underwent the structured clinical interview for depression and completed the Hamilton Depression Rating Scale (HAM-D). RESULTS: After 4 months of treatment, 41% of the participants achieved remission, defined as no longer meeting the criteria for major depressive disorder (MDD) and a HAM-D score of <8. Patients receiving active treatments tended to have higher remission rates than the placebo controls: supervised exercise = 45%; home-based exercise = 40%; medication = 47%; placebo = 31% (p = .057). All treatment groups had lower HAM-D scores after treatment; scores for the active treatment groups were not significantly different from the placebo group (p = .23). CONCLUSIONS: The efficacy of exercise in patients seems generally comparable with patients receiving antidepressant medication and both tend to be better than the placebo in patients with MDD. Placebo response rates were high, suggesting that a considerable portion of the therapeutic response is determined by patient expectations, ongoing symptom monitoring, attention, and other nonspecific factors

Antidepressant · Depression (economics) · Fluoxetine · Hamilton Rating Scale for Depression · Major depressive disorder · Major depressive episode · Mood · Pharmacotherapy · Physical therapy · Pill · Placebo · Psychiatry · Randomized controlled trial · Rating scale · Sertraline · Cardiovascular and exercise physiology · Exercise and Physiological Responses · Internal Medicine · Medicine · Physical Activity and Health · Psychology