Jesús López-Torres Hidalgo1,2, Joseba Rabanales Sotos3. 1. Albacete Zone VIII Health Center, Albacete, Spain jesusl@sescam.org. 2. Faculty of Medicine, University of Castile-La Mancha, Albacete, Spain. 3. Albacete Faculty of Nursing, University of Castile-La Mancha, Albacete, Spain.
Abstract
PURPOSE: We sought to compare the effectiveness of physical exercise with that of treatment with antidepressant drugs routinely used in clinical practice, in terms of decreasing depressive symptomatology in patients aged ≥65 years who present with clinical criteria of a depressive episode. METHODS: We conducted a randomized clinical trial in a primary care setting. A total of 347 patients aged ≥65 years with a clinically significant depressive episode were randomized to participation in a supervised physical exercise program or to receive antidepressant treatment by their general practitioners. RESULTS: Intention-to-treat analysis showed that the cumulative incidence of improvement in depressive symptomatology (Montgomery-Åsberg Depression Rating Scale score <10) in the physical activity (PA) group after 1 month was not significantly different from that in the antidepressant treatment (AT) group. However, the proportion of those who showed improvement was significantly greater (P <.01) in the AT group (60.6% and 49.7%) compared to the PA group (45.6% and 32.9%) at the end of 3 and 6 months, respectively. The number of withdrawals was greater in the PA group (39.2% and 58.2%) compared to the AT group (22.6% and 40.0%) at 3 and 6 months, respectively, yet the proportion of participants with adverse side effects was greater in the AT group (8.9% vs 22.5%; P = .007). CONCLUSION: Although improvement was initially similar in both treatment groups, AT was superior in the medium term, despite giving rise to a greater number of adverse effects.
RCT Entities:
PURPOSE: We sought to compare the effectiveness of physical exercise with that of treatment with antidepressant drugs routinely used in clinical practice, in terms of decreasing depressive symptomatology in patients aged ≥65 years who present with clinical criteria of a depressive episode. METHODS: We conducted a randomized clinical trial in a primary care setting. A total of 347 patients aged ≥65 years with a clinically significant depressive episode were randomized to participation in a supervised physical exercise program or to receive antidepressant treatment by their general practitioners. RESULTS: Intention-to-treat analysis showed that the cumulative incidence of improvement in depressive symptomatology (Montgomery-Åsberg Depression Rating Scale score <10) in the physical activity (PA) group after 1 month was not significantly different from that in the antidepressant treatment (AT) group. However, the proportion of those who showed improvement was significantly greater (P <.01) in the AT group (60.6% and 49.7%) compared to the PA group (45.6% and 32.9%) at the end of 3 and 6 months, respectively. The number of withdrawals was greater in the PA group (39.2% and 58.2%) compared to the AT group (22.6% and 40.0%) at 3 and 6 months, respectively, yet the proportion of participants with adverse side effects was greater in the AT group (8.9% vs 22.5%; P = .007). CONCLUSION: Although improvement was initially similar in both treatment groups, AT was superior in the medium term, despite giving rise to a greater number of adverse effects.
Authors: Antonio Lobo; Lorenzo Chamorro; Antonio Luque; Rafael Dal-Ré; Xavier Badia; Eva Baró Journal: Med Clin (Barc) Date: 2002-04-13 Impact factor: 1.725
Authors: Felipe B Schuch; Davy Vancampfort; Simon Rosenbaum; Justin Richards; Philip B Ward; Nicola Veronese; Marco Solmi; Eduardo L Cadore; Brendon Stubbs Journal: Braz J Psychiatry Date: 2016-07-18 Impact factor: 2.697