In a recent study published in the Journal of Affective Disorders, a team of researchers from the Netherlands compared the effects of antidepressants and exercise therapy in the form of group-based running on the physical and mental health of patients with anxiety disorders and depression.

Study: Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. Image Credit: Jacob Lund / Shutterstock

Background

A growing body of evidence indicates that anxiety and depressive disorders can impact not only mental health but can also affect physical health, including immunity, strength, and heart health. After psychotherapy, antidepressants are believed to be the next most effective treatment option that can be tolerated sufficiently. However, the response to antidepressants and the intensity of the side effects varies for different patients.

Exercise therapy has been recommended as an alternate form of treatment for anxiety and depression. Studies have found that exercise interventions for cases of mild to moderate depression are as effective as psychotherapy and antidepressants. Furthermore, for cases of severe depression, exercise therapy continues to be helpful as a complementary therapy. While the studies on the impact of exercise therapy on anxiety are not as numerous as the ones on depression, the current findings are promising.

Although the impact of exercise therapy and antidepressants on mental health outcomes in patients with anxiety and depressive disorders are similar, given that the underlying pathophysiological mechanisms differ, the impact of both treatments on the physical health of the patients might differ.

About the study

In the present study, the researchers conducted an intervention study spanning 16 weeks to examine how antidepressants and group running therapy differed in their effects on the mental and physical health of patients with anxiety and depressive disorders.

The study examined mental health outcomes such as diagnosis status and severity of symptoms, while physical health outcomes included indicators of immune and metabolic health, variability in heart rate, lung function, body weight, fitness, and hand grip strength. The researchers hypothesized that the mental health outcomes would not be very different for the two interventions, but the ones related to physical health would differ.

Participants were included in the study if they were between the ages of 18 and 70 years and had a current diagnosis of major depressive disorder or an anxiety disorder such as panic disorder, generalized anxiety disorder, agoraphobia, or social phobia. Individuals who had used antidepressants in the preceding two weeks, exercised regularly, were at acute suicidal risk, were pregnant, or had any contraindications to either of the two interventions were excluded.

Escitalopram, which is a selective serotonin reuptake inhibitor with low side effects and high effectiveness, was the antidepressant used as one of the two interventions. An administration log and the patient’s diary were used to determine adherence to the intervention.

The other intervention included 45 minutes of supervised outdoor running two to three times each week for 16 weeks. All the participants undergoing this intervention wore a heart rate monitor, which helped confirm adherence to the exercise regimen.

Fasting blood sugar samples from the participants were used to assess the levels of glucose, triglycerides, and high-density lipoprotein cholesterol. Serum levels of interleukin-6, interferon-γ, tumor necrosis factor-α, and C-reactive protein were also measured. Various other tests were used to assess autonomic nervous system activity, fitness levels, and lung function.

Results

The study found that while the mental health outcomes for the two interventions were comparable, running therapy had a significantly better impact on physical health outcomes than antidepressants.

Physical health characteristics such as body weight, waist circumference, heart rate, variability in heart rate, and blood pressure differed significantly between the two interventions. The group undergoing running therapy showed more improvements in all these factors than the one being treated with antidepressants. The C-reactive protein and triglyceride levels were also found to be different between running therapy and antidepressant interventions.

The results also showed that the inclusion type did not impact the treatment effects, and the differences in outcomes were the same when the participants were randomized or when they chose the intervention according to their preference. However, the adherence to the treatments differed significantly, with antidepressants having a higher adherence rate (82%) than running therapy (52%). The researchers believe that this finding is of importance since it can have substantial implications in the recommendation or prescription of a treatment for anxiety or depression.

Conclusions

Overall, the findings reported that while the remission rates of anxiety disorders and depression were similar for running therapy and antidepressants, the physical health outcomes differed significantly between the two interventions.

Treatment with antidepressants resulted in increased blood pressure, waist circumference, triglycerides, and lower variability in heart rate, indicating a higher risk of metabolic syndrome. In contrast, running therapy showed improvements in all the metabolic and cardiovascular indicators. These findings highlight the importance of including exercise as a standard practice in the treatment of anxiety disorders and depression.