Overview
- The review pooled about 5,000 adults across 73 randomized trials and found moderate symptom reductions at treatment end with structured physical activity.
- Direct comparisons suggested little to no difference between exercise, psychological therapy, and antidepressant medication in short‑term outcomes.
- Adverse events were uncommon with exercise and mostly minor musculoskeletal injuries, whereas drug treatments more often reported fatigue, sexual dysfunction, and gastrointestinal symptoms.
- Signals from the trials linked light‑to‑moderate intensity activity and completing roughly 13–36 sessions with greater improvements, with no single exercise type proving superior.
- Methodological limits—small samples, brief follow‑up, limited allocation concealment and blinding—led authors to call for larger, longer, higher‑quality studies and to recommend exercise as a useful complement rather than an automatic replacement.