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Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: a systematic review and network meta-analysis of randomised controlled trials
Network meta-analysis of 21 RCTs (n=2,551) in non-severe depression finds exercise, SSRI-class antidepressants, and combined treatment each beat waitlist controls; direct comparisons show no significant efficacy difference between exercise monotherapy and antidepressants on continuous depression scores but higher dropout in exercise arms.
Design
- 21 RCTs, n = 2,551, 25 treatment comparisons
- Population: non-severe depression definitions per included trials
Comparative efficacy (abstract headline)
- Exercise vs antidepressants: pooled SMD −0.12 (95% CI −0.33 to 0.10) → no statistically significant difference on continuous depression scores
- Dropout: RR 1.31 (95% CI 1.09–1.57) higher in exercise vs antidepressant arms
Evidence hygiene
Network geometry sparse for some nodes—combination therapy arms need clinician oversight; not generalisable to severe depression or bipolar illness.
Publication
Recchia F, Leung CK, Chin EC, et al. Br J Sports Med. 2022 Dec;56(24):1375-1380. PMID 36113975.
Outcomes
- Effect Size (Cohen's d / SMD)-0.12d (Cohen's d)
- Dropout higher with exercise than antidepressants: risk ratio 1.31 (95% CI 1.09–1.57) across included trials—adherence disadvantage for exercise-only prescriptions.