Revisiting the exercise recommendations in the 2023 CANMAT Guidelines for Major Depressive Disorder

The Canadian Network for Mood and Anxiety Treatments’ 2023 Update on Clinical Guidelines for the Management of Major Depressive in Adults was a much-anticipated update to the 2016 Guidelines. The Guidelines feature several significant changes to the 2016 exercise prescription for depression, such as downgrading the level of evidence and altering recommendations around exercise intensity. However, these changes were not communicated to readers and their rationale is not readily apparent. To better understand the 2023 exercise prescription, we reviewed the Guidelines’ 964 references for relevant citations. This Letter to the Editor documents the results of our review, and proposes a revised evidence-based exercise prescription.