9/22/2000 – Exercise better than Zoloft.

Seems like exercise works better than SSRI’s!

What a surprise. After 16 weeks, patients who exercised
showed statistically significant and comparable improvement
relative to those who took Zoloft, or those who took the Zoloft and

Be sure to look at the wide disparity in the percentage on drugs
who relapse into depression after eight weeks vs. those not on

Here’s the complete story out of Duke University.

Effect of exercise on reducing major depression appears to be

DURHAM, N.C. After demonstrating that 30 minutes of brisk
exercise three times a week is just as effective as drug therapy
in relieving the symptoms of major depression in the short term,
Duke University Medical Center researchers have now shown
that continued exercise greatly reduces the chances of the
depression returning.

Last year, the Duke researchers reported on their study of 156
older patients diagnosed with major depression which, to their
surprise, found that after 16 weeks, patients who exercised
showed statistically significant and comparable improvement
relative to those who took anti-depression medication, or those
who took the medication and exercised.

The new study, which followed the same participants for an
additional six months, found that patients who continued to
exercise after completing the initial trial were much less likely to
see their depression return than the other patients. Only 8
percent of patients in the exercise group had their depression
return, while 38 percent of the drug-only group and 31 percent of
the exercise-plus-drug group relapsed.

“The important conclusion is that the effectiveness of exercise
seems to persist over time, and that patients who respond well
to exercise and maintain their exercise have a much smaller risk
of relapsing,” said lead researcher, Duke psychologist James
Blumenthal, who published the results of his team’s study in the
October issue of the journal Psychosomatic Medicine.

The research was supported by grants from the National
Institutes of Health (NIH). The Duke researchers are now using
a new $3 million NIH grant to better understand the subtle
factors that may explain the positive effects of exercise in a new
trial that begins enrolling patients this month.

“We found that there was an inverse relationship between
exercise and the risk of relapsing the more one exercised, the
less likely one would see their depressive symptoms return,”
Blumenthal explained. “For each 50-minute increment of
exercise, there was an accompanying 50 percent reduction in
relapse risk. “Findings from these studies indicate that a modest
exercise program is an effective and robust treatment for
patients with major depression,” he continued. “And if these
motivated patients continue with their exercise, they have a much
better chance of not seeing their depression return.”

Researchers were surprised that the group of patients who took
the medication and exercised did not respond as well as those
who only exercised.

“We had assumed that exercise and medication together would
have had an additive effect, but this turned out not to be the
case,” Blumenthal said. “While we don’t know the reasons for
this, some of the participants were disappointed when they
found out they were randomized to the exercise and medication
group. To some extent, this `anti-medication’ sentiment may
have played a role by making patients less excited or enthused
about their combined exercise and medication program.”

He suggested that exercise may be beneficial because patients
are actually taking an active role in trying to get better. “Simply
taking a pill is very passive,” he said. “Patients who exercised
may have felt a greater sense of mastery over their condition and
gained a greater sense of accomplishment. They may have felt
more self-confident and competent because they were able to
do it themselves, and attributed their improvement to their ability
to exercise.”

Once patients start feeling better, they tend to exercise more,
which makes them feel even better, Blumenthal said. The
greatest risk for these patients, since they are older, would be to
suffer an injury or illness that would interrupt their exercise
routine, he added.

While the researchers enrolled middle-aged and elderly people
in their study, Blumenthal said it is logical to assume that the
results would hold true for the general population, since older
people tend to have additional medical problems or infirmities
that might make regular exercise more difficult than for younger

Researchers used the anti-depressant sertraline (trade name
Zoloft), which is a member of a class of commonly used
anti-depressants known as selective serotonin reuptake
inhibitors (SSRI).

Blumenthal cautioned that the study did not include patients who
were acutely suicidal or had what is termed psychotic
depression. Also, since patients were recruited by
advertisements, these patients were motivated to get better and
interested in exercise.


The research team included, from Duke, Michael Babyak, Steve
Herman, Parinda Khatri, Dr. Murali Doraiswamy, Kathleen
Moore, Teri Baldewicz and Dr. Ranga Krishnan. Edward
Craighead, from the University of Colorado at Boulder also

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