Researchers randomly assigned 202 depressed older adults (average age, 53 years old, 75% women) to four conditions: supervised group exercise 3 times a week, at-home aerobic exercise (unsupervised), sertraline, 50-200 mg/day, or placebo. After 4 months of treatment, the remis- sion rates were as follows: Supervised exercise, 45%; home-based exercise, 40%; sertraline, 47%; placebo, 31%. When the results of all the active treat- ments combined were compared to placebo, they were almost superior, with p = .057, close to the p = .05 threshold for statistical significance (Blumenthal JA et al., Psychosom Med 2007;69:587-596).

TCPR’s Take: In an earlier study, this same group of researchers found that supervised exercise led to a 47% remission rate, vs. a 56% remission rate on sertraline (difference not statistically significant). They replicated the study because the earlier study did not include a placebo group, making it unclear to what extent non-specific factors were at play for both treatments. Unfortunately, in this paper the authors chose not to separate out the different active treat- ments in their presentation of their statistical tests, making us wonder how robust the findings actually were. Nonetheless, prescribing an aerobics class to patients with mild to moderate depression appears to be a reasonable treatment strategy, and it provides obvious physical health benefits as well.