Overview
- The updated Cochrane analysis pooled 73 randomized trials with about 5,000 adults, adding 35 new studies to earlier reviews.
- Direct comparisons found exercise produced similar reductions in depressive symptoms to psychotherapy with moderate-certainty evidence and to antidepressants with lower certainty.
- Adverse events in exercise groups were infrequent and typically mild musculoskeletal injuries, whereas antidepressants more often involved fatigue, gastrointestinal issues and sexual dysfunction.
- No single modality proved superior, though light to moderate intensity performed well, with benefits noted when participants completed roughly 13 to 36 sessions and some advantages seen for combined programs or resistance training.
- Authors and independent experts highlight methodological limitations and limited long-term follow-up, recommending exercise as an accessible option or adjunct and calling for larger, more rigorous, longer-duration trials.