Exercise for depression

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Exercise for depression: efficacy, safety and clinical trial

implications.

Psychopharmacol Bull. 2008;41(4):65-75.Links

Dunlop BW, Self RL.

Exercise is gaining interest as a treatment for major depressive

disorder (MDD). Though not yet fully established as an efficacious

therapy for psychiatric disorders, exercise has well-established

benefits for physcial health and overall well-being. However, there

are potential health risks to exercise that need to be considered

before recommending physical activity to a patient.

We present the

case of a 48 year-old woman who develolped significant elevations in

creatine kinase and liver enzyme levels after three work-out sessions

consisting of cardiovascular training on an elliptical machine and

weightlifting. The elevations resolved with rest, then recurred when

the patient again began exercising. These elevations occurred while

the patient was participating in a double-blind, placebo-control

phase II clinical trial of an experimental medication for MDD. This

case highlights several aspects of the appropriate implementation of

exercise recommendations in the psychiatric setting. Initiation of

exercise regimens is not prohibited in clinical trials, and may be

self-initiated by the depressed patient or recommended by the

treating physician. This case also highlights that the value of

placebo controls in clinical trials of experimental treatments

applies to safety as well as efficacy factors.

Exercise as a

treatment for depression carries both potential benefit for

depressive symptoms and risk for adverse events. The design of

clinical trials would be strengthened by consideration of these

effects of exercise in the future.

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Carruthers

Wakefield, UK