The Role of Exercise in Managing Depression: Clinical Insights from Recent Reviews

A recent review of 73 randomized trials (nearly 5,000 adults) reports that structured exercise reduces depressive symptoms to a similar degree as psychological therapy (moderate‑certainty evidence from a subset of trials) and, in some analyses, to antidepressants (low‑certainty evidence). The findings support exercise as a clinically meaningful nonpharmacologic option to consider within treatment plans.

The evidence base comprises randomized controlled trials enrolling adults with major depressive disorder or depressive symptoms identified in primary care and community settings, primarily parallel‑group RCTs. Primary endpoints were validated depression symptom scales; pooled analyses used standardized mean differences to quantify effect sizes. Trial durations were generally short and control groups varied across studies.

Pooled comparisons versus no treatment indicate that exercise produces moderate reductions in depressive symptoms. In head‑to‑head analyses, exercise showed a similar magnitude of effect to psychological therapy (moderate‑certainty evidence from ten trials) and was comparable to antidepressants in some analyses (low‑certainty evidence). Trials reporting larger improvements commonly implemented light‑to‑moderate intensity programs delivered across roughly 13–36 sessions.

Program characteristics differed across trials. Some data suggest mixed aerobic‑plus‑resistance programs and resistance training outperformed aerobic‑only regimens. For practical prescription, clinicians can tailor programs to patient preference and capacity, favoring structured, progressive plans and routine symptom monitoring to track response.

Interpretation is tempered by trial heterogeneity, varied control conditions, short follow‑up, and risk‑of‑bias concerns in some studies. The overall certainty is moderate for several comparisons but low for others; larger, longer, low‑bias trials are needed to refine effect estimates and document durability.

Key Takeaways:

• Exercise produces moderate, clinically meaningful reductions in depressive symptoms similar to psychotherapy (moderate‑certainty evidence) and comparable to antidepressants in some analyses (low‑certainty evidence).
• Mixed programs and resistance training showed greater benefits than aerobic‑only regimens in several trials; larger effects were associated with light‑to‑moderate intensity across ~13–36 sessions.
• Evidence quality is moderate for multiple comparisons but limited by heterogeneity and short follow‑up; further long‑term, low‑bias RCTs are needed.