Exercise As An Augmentation To Antidepressant Treatment For Depression

Abstract

PURPOSE: To examine the efficacy of aerobic exercise to augment anti-depressant effects of a 12-week Venlafaxine trial to treat Major Depression in older (60-79 yrs.) and younger (20-39 yrs.) adults. METHODS: Participants included adults with Major Depression. All participants were sedentary (<20 minutes exercise 3 times per week), had no contraindications for aerobic exercise, were cognitively unimpaired, and were eligible to undergo an MRI. Participants were randomized to a 12-week trial of Venlafaxine only or Venlafaxine + Aerobic Exercise. All participants met with a clinician biweekly for medication management. The exercise group additionally received 1 hour of supervised aerobic exercise 3 times per week for 12-weeks. All participants completed cardiorespiratory fitness testing (VO2 submax) and the Montgomery-Asberg Depression Rating Scale (MADRS) at baseline and follow-up. RESULTS: Twelve participants were randomized, but two dropped out (one from each group). The resulting sample included 10 adults (mean age = 38.7, 40% male, 90% Caucasian). At baseline, participants had a mean MADRS score of 26.10 (5.04) and a mean estimated VO2max of 29.61(6.01). Across both groups, there was a decrease in depressive symptoms over 12-weeks (t= 6.60, p< 0.001). The Venlafaxine only group (N=5) showed a mean decrease of 16 points on the MADRS and the exercise group (N=5) showed a mean decrease of 19.8 points. The exercise group showed a mean increase of 4.74% (SD =12.11%) in fitness, while the Venlafaxine only group showed a mean decrease of 8.71% (SD = 17.05%) (p=0.20). There was a negative association between change in fitness level and change in depressive symptoms (r = -0.71, p = 0.03). The trajectories of change in depressive symptoms across the treatment groups did not differ (MADRS x Treatment F= 0.112 p = 0.75). The exercise and no-exercise group showed the same trajectory of changes in depressive symptoms over the first 4 weeks, but the exercise group showed more consistent decline than the Venlafaxine only group for the last 2 months. CONCLUSIONS: Participants showed improvement in depression symptoms across both treatment groups. Change in fitness was negatively associated with change in depressive symptoms, suggesting a dose-response effect of exercise on depressive symptoms. Supported by NIH Grant: P30 MH90333