Antidepressants or running therapy: comparing effects on mental and physical health in patients with depression and anxiety disorders
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BACKGROUND: Antidepressant medication and running therapy are both effective treatments for patients with depressive and anxiety disorders. However, they may work through different pathophysiological mechanisms and could differ in their impact on physical health. This study examined effects of antidepressants versus running therapy on both mental and physical health. METHODS: According to a partially randomized patient preference design, 141 patients with depression and/or anxiety disorder were randomized or offered preferred 16-week treatment: antidepressant medication (escitalopram or sertraline) or group-based running therapy ≥2 per week. Baseline (T0) and post-treatment assessment at week 16 (T16) included mental (diagnosis status and symptom severity) and physical health indicators (metabolic and immune indicators, heart rate (variability), weight, lung function, hand grip strength, fitness). RESULTS: Of the 141 participants (mean age 38.2 years; 58.2 % female), 45 participants received antidepressant medication and 96 underwent running therapy. Intention-to-treat analyses showed that remission rates at T16 were comparable (antidepressants: 44.8 %; running: 43.3 %; p = .881). However, the groups differed significantly on various changes in physical health: weight (d = 0.57; p = .001), waist circumference (d = 0.44; p = .011), systolic (d = 0.45; p = .011) and diastolic (d = 0.53; p = .002) blood pressure, heart rate (d = 0.36; p = .033) and heart rate variability (d = 0.48; p = .006). LIMITATIONS: A minority of the participants was willing to be randomized; the running therapy was larger due to greater preference for this intervention. CONCLUSIONS: While the interventions had comparable effects on mental health, running therapy outperformed antidepressants on physical health, due to both larger improvements in the running therapy group as well as larger deterioration in the antidepressant group. TRIAL REGISTRATION: Trialregister.nl Number of identification: NTR3460.
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Antidepressant medications are considered a first-line treatment for GAD and have been associated with an increase in C-reactive protein.
“This is in contrast to antidepressant medications, which are considered a first-line treatment for GAD and have been associated with an increase in C-reactive protein (Verhoeven et al., 2023).”
From Inflammatory markers changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial (2024) · cites this paper as Verhoeven et al., 2023
Incorporating psychological interventions alongside antidepressant medications has augmented benefit.
“In light of these challenges, several studies indicate the augmented benefit of incorporating psychological interventions alongside antidepressant medications (Breedvelt 2021; Thapar 2022; Verhoeven 2023).”
From Psychotherapeutic treatments for depression in older adults (2024) · cites this paper as Verhoeven 2023
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- Authors
- Verhoeven, J. E., Han, L. K. M., Lever-van Milligen, B. A., Hu, M. X., Révész, D., Hoogendoorn, A. W., Batelaan, N. M., van Schaik, D. J. F., van Balkom, A. J. L. M., van Oppen, P., & Penninx, B. W. J. H.
- Affiliations
- Amsterdam Neuroscience (NL)
- Tilburg University (NL)
- Corresponding author
- Verhoeven, Josine E.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2023-05
- Volume
- 329
- Pages
- 19-29
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4321483614
- Cited by
- 112
- References
- 60
- Citations by year
- 2026: 28 · 2025: 43 · 2024: 32 · 2023: 9
- FWCI
- 19.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw (636310017)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (91811602)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- antidepressants, running therapy, depression, anxiety disorders, escitalopram, sertraline, physical health, weight, blood pressure, heart rate variability, exercise therapy, patient preferences, remission
- MeSH terms
- Adult, Antidepressive Agents, Anxiety Disorders, Depression, Female, Humans, Male, Hand Strength, Sertraline
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