4 ms·

The Cochrane report says the evidence for exercise as an intervention to improve depression is "inconclusive", whereas you say it "probably doesn't" help, which

The Cochrane report says the evidence for exercise as an intervention to improve depression is "inconclusive", whereas you say it "probably doesn't" help, which isn't the same thing. The various reviews of exercise-based interventions illustrate how complex it can be to implement trials and interpret their results. Frankly I'd encourage exercise in a depressed patient, rather than say it "probably doesn't help". There are numerous other benefits that could probably outweigh risks (although these should obviously be assessed on a case-by-case basis) and interventions should seek to minimise nocebo as well as maximise placebo -- ethically of course. It just might work for that patient, and actually that is a perfectly rational basis for treatment sometimes.

DanBC 12y ago
> When only high-quality trials were included, exercise had only a small effect on mood that was not statistically significant. That seems pretty clear. > There are numerous other benefits Yes, recommend exercise because it is undoubtedly a good thing. Just don't recommend it as a treatment for depression, because "exercise [has] only a small effect on mood that [is] not statistically significant."
- kbutler 12y ago
  Given a choice between exercise with questionable effectiveness and lots of good side effects, and anti-depressant drugs with questionable effectiveness and lots of negative side effects, I'd certainly try exercise, particularly in less-severe cases, where anti-depressant drugs do no better than a placebo. http://www.nimh.nih.gov/about/director/2011/antidepressants-a-complicated-picture.shtml http://www.nimh.nih.gov/about/director/2011/antidepressants-...
  - DanBC 12y ago
    Good thing I'm not pushing for medication either. Front line treatment is a talking therapy, probably CBT. Or, for moderate or severe depression the recommendation is a talking therapy and medication. Doubts about medication are weaker when the depression is more severe btw Your link repeats some things I've said (untreated suicide carries a risk of suicide; "In more severe forms of depression, antidepressants show greater efficacy." Etc)
- deleted 12y ago
  [deleted]

DanBC 12y ago

> When only high-quality trials were included, exercise had only a small effect on mood that was not statistically significant. That seems pretty clear. > There are numerous other benefits Yes, recommend exercise because it is undoubtedly a good thing. Just don't recommend it as a treatment for depression, because "exercise [has] only a small effect on mood that [is] not statistically significant."

kbutler 12y ago
Given a choice between exercise with questionable effectiveness and lots of good side effects, and anti-depressant drugs with questionable effectiveness and lots of negative side effects, I'd certainly try exercise, particularly in less-severe cases, where anti-depressant drugs do no better than a placebo. http://www.nimh.nih.gov/about/director/2011/antidepressants-a-complicated-picture.shtml http://www.nimh.nih.gov/about/director/2011/antidepressants-...
- DanBC 12y ago
  Good thing I'm not pushing for medication either. Front line treatment is a talking therapy, probably CBT. Or, for moderate or severe depression the recommendation is a talking therapy and medication. Doubts about medication are weaker when the depression is more severe btw Your link repeats some things I've said (untreated suicide carries a risk of suicide; "In more severe forms of depression, antidepressants show greater efficacy." Etc)
deleted 12y ago
[deleted]