Key result
Running therapy matches antidepressants for mental health remission while improving physical health outcomes.
Why the study?
Antidepressants and running therapy are both effective for depression and anxiety, but may act through different mechanisms and differ in physical health impacts.
Does running therapy improve mental and physical health compared to antidepressant medication in patients with depression and anxiety disorders?
Does running therapy improve mental and physical health compared to antidepressant medication in patients with depression and anxiety disorders?
Effect estimate: Cohen's d 0.02
Absolute Event Rate: 43.3% vs 44.8%
p-value: p=0.881
Running therapy and antidepressant medication offer comparable mental health benefits for depression and anxiety, but running therapy provides superior physical and cardiovascular health improvements.
Running therapy offers a viable alternative with added physical gains; extends RCT evidence for exercise in depression and anxiety management.
BACKGROUND: 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. METHODS: 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). RESULTS: 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). LIMITATIONS: A minority of the participants was willing to be randomized; the running therapy was larger due to greater preference for this intervention. CONCLUSIONS: 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. TRIAL REGISTRATION: Trialregister.nl Number of identification: NTR3460.
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Verhoeven et al. (2023) studied Depression and anxiety disorders (n=141). Running therapy vs. Antidepressant medication (escitalopram 10-20 mg/day or sertraline 50-150 mg/day) was evaluated on Remission (no longer meeting criteria for current depressive or anxiety disorder at 16 weeks) (Cohen's d 0.02, p=0.881). Running therapy and antidepressant medication resulted in comparable mental health remission rates (43.3% vs 44.8%), but running therapy led to significantly more favorable physical health outcomes.
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