Antidepressant Efficacy of Adjunctive Aerobic Activity and Associated Biomarkers in Major Depression: A 4-Week, Randomized, Single-Blind, Controlled Clinical Trial

Carregando...
Imagem de Miniatura
Citações na Scopus
40
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Citação
PLOS ONE, v.11, n.5, article ID e0154195, 11p, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Major depressive disorder (MDD) is a highly prevalent, heterogeneous and systemic medical condition. Treatment options are limited, and recent studies have suggested that physical exercise can play an important role in the therapeutics of MDD. The aim of this study was to evaluate the antidepressant efficacy of adjunctive aerobic activity in association with pharmacotherapy (selective serotonin reuptake inhibitor) in symptomatic MDD as well as its association with physiological biomarkers. Methods In this randomized, single-blind, add-on, controlled clinical trial, 57 patients (18-55 years of age) were followed-up for 28 days. All patients were drug-free, had been diagnosed with symptomatic MDD and received flexible dose of sertraline during the trial. Patients were randomized to either a 4-week program (4x/week) of add-on aerobic exercise (exercise group, N = 29) or no activity (control group, N = 28). Depression severity was assessed using the Hamilton Rating Scale for Depression (HAM-D) as the primary outcome. At baseline and endpoint, all patients underwent a comprehensive metabolic/cardiopulmonary exercise testing-including determination of maximal oxygen uptake (VO(2)max), VO2 at the second ventilatory threshold (VO2-VT2), and oxygen pulse (O-2 pulse). Results Depression scores significantly decreased in both groups after intervention. Importantly, patients in the aerobic exercise group required lower sertraline dose compared to the control group (sertraline monotherapy). The VO(2)max and O-2 pulse parameters increased over time only in the exercise group and remained unchanged in the control group. Conclusions The present findings suggest that a 4-week training of aerobic exercise significantly improves functional capacity in patients with MDD and may be associated with antidepressant efficacy. This approach may also decrease the need for higher doses of antidepressants to achieve response. Further studies in unmedicated and treatment-resistant MDD patients are needed in order to confirm the utility of short-term aerobic exercise as an alternative therapeutic approach in MDD.
Palavras-chave
Referências
  1. Krogh J, 2010, J AFFECT DISORDERS, V125, P189, DOI 10.1016/j.jad.2010.01.009
  2. Garber CE, 2011, MED SCI SPORT EXER, V43, P1334, DOI 10.1249/MSS.0b013e318213fefb
  3. Knochel C, 2012, PROG NEUROBIOL, V96, P46, DOI 10.1016/j.pneurobio.2011.11.007
  4. Silveira H, 2013, NEUROPSYCHOBIOLOGY, V67, P61, DOI [10.1159/000345160, 10.1159/0]
  5. Schuch FB, 2011, J AFFECT DISORDERS, V133, P615, DOI 10.1016/j.jad.2011.04.030
  6. Tolmunen T, 2006, EUR J EPIDEMIOL, V21, P701, DOI 10.1007/s10654-006-9038-5
  7. Babyak M, 2000, PSYCHOSOM MED, V62, P633
  8. Rethorst CD, 2013, MOL PSYCHIATR, V18, P1119, DOI 10.1038/mp.2012.125
  9. Josefsson T, 2014, SCAND J MED SCI SPOR, V24, P259, DOI 10.1111/sms.12050
  10. Trivedi MH, 2006, CLIN TRIALS, V3, P291, DOI 10.1191/1740774506cn151oa
  11. Dunn AL, 2005, AM J PREV MED, V28, P1, DOI 10.1016/j.amepre.2004.09.003
  12. Sui XM, 2009, J PSYCHIATR RES, V43, P546, DOI 10.1016/j.jpsychires.2008.08.002
  13. Kessler RC, 2005, ARCH GEN PSYCHIAT, V62, P617, DOI 10.1001/archpsyc.62.6.617
  14. Blumenthal JA, 2012, ACSMS HEALTH FIT J, V16, P14, DOI 10.1249/01.FIT.0000416000.09526.eb
  15. Blumenthal JA, 2007, PSYCHOSOM MED, V69, P587, DOI 10.1097/PSY.0b013e318148c19a
  16. Mead GE, 2009, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD004366.pub4
  17. Mota-Pereira J, 2011, J PSYCHIATR RES, V45, P1005, DOI 10.1016/j.jpsychires.2011.02.005
  18. APA, 1994, DIAGN STAT MAN MENT
  19. Chalder M, 2012, BRIT MED J, V344, DOI 10.1136/bmj.e2758
  20. Cheik NC, 2003, REV BRAS CIENC MOV, V11, P45
  21. Cooney G. M., 2013, COCHRANE DB SYST REV, V12, P9, DOI 10.1002/14651858.CD004366.PUB6
  22. Edvardsen E, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0085276
  23. Krogh Jesper, 2014, Front Psychiatry, V5, P89, DOI 10.3389/fpsyt.2014.00089
  24. Reaburn P., 2013, J SCI MED SPORT
  25. Rimer J, 2012, COCHRANE DB SYST REV, V7
  26. Serra S., 1997, ARQ BRAS CARDIOL, V68
  27. World Health Organization, 2006, TECHN REC DEPR
  28. Zarshenas S, 2013, DEPRESS RES TREAT, DOI [10.1155/2013/132684, DOI 10.1155/2013/132684]