Running therapy significantly improved the composite immunometabolic depression index compared to antidepressant use (Cohen's d 0.85, p < 0.001) in patients with depressive and anxiety disorders.
RCT (n=141)
Open-label
Partially randomized patient preference design
No
Does running therapy improve immunometabolic depression features compared to antidepressants in patients with depressive and anxiety disorders?
Exercise more effectively targets immunometabolic dysregulation than antidepressants in patients with depression and anxiety disorders.
Standardized Mean Difference: 0.85
Absolute Event Rate: -0.5% vs 1.3%
p-value: p=<0.001
BACKGROUND: Exercise promotes immunometabolic health and is increasingly recognized as an effective depression treatment. Exercise may be beneficial for patients with immunometabolic depression (IMD), who experience inflammatory and metabolic dysregulations and may respond less to antidepressants. This secondary analysis of the MOTAR study compared the effects of running therapy and antidepressants on IMD features among patients with depression and/or anxiety disorder. We additionally assessed whether baseline IMD moderated intervention effects on depression. METHODS: Participants received 16 weeks of group-based running therapy (N = 96) or escitalopram/sertraline (N = 45) in a partially randomized patient preference design. IMD features included atypical, energy-related symptom (AES) severity, inflammation index (CRP, IFN-γ, IL-6, TNF-α), metabolic syndrome index, three metabolite principle components (PC) (derived from 73 metabolites) and a composite IMD index. RESULTS: Interventions differed in changes in the metabolic syndrome index (d = 0.59, p = 0.026) and IMD index (d = 0.85, p < 0.001). While running therapy decreased both outcomes, the antidepressant group showed an increased IMD index. Although groups did not differ statistically significant in changes in AES severity, inflammation index, and metabolite PC1, results indicated a consistent trend towards greater improvement with running therapy across these outcomes as well (d = 0.38 to 0.52). Baseline IMD did not moderate intervention effects on depression outcomes. CONCLUSIONS: This study suggests that exercise more effectively targets the IMD dimension than antidepressants. Patients with IMD did not benefit more from running therapy than antidepressants in terms of reductions in depression. Exercise should be considered an alternative or complementary treatment to particularly reduce IMD features in depressed patients. TRIAL REGISTRATION: Trialregister.nl Number of identification: NTR3460.
Vreijling et al. (Wed,) conducted a rct in Major Depressive Disorder and/or Anxiety Disorder (n=141). Running therapy vs. Antidepressant medication (escitalopram 10-20 mg/day or sertraline 50-100 mg/day) was evaluated on Change in composite immunometabolic depression (IMD) index (Cohen's d 0.85, p=<0.001). Running therapy significantly improved the composite immunometabolic depression index compared to antidepressant use (Cohen's d 0.85, p < 0.001) in patients with depressive and anxiety disorders.