Physical exercise in depression: benefits, physiological effects, and clinical applications

Abstract

Introduction. Depression is a highly prevalent psychiatric disorder worldwide. The complex etiology of this disease remains unclear but is believed to primarily involve neurotransmitter imbalances and neuroendocrine alterations. Currently, pharmacotherapy is the most used treatment; however, it has limitations in managing mild to moderate depression, making it necessary to adopt alternative approaches, such as physical exercise (PE). Objectives. To assess the comparative efficacy of pharmacotherapy and PE in the treatment of mild to moderate depression. Additionally, we will discuss the physiological mechanisms of PE involved in the pathophysiology of depression and the main challenges in applying this therapy. Method. The selection of studies for this integrative review was conducted through an advanced search in the following databases: PubMed, Scielo, and Lilacs, using the descriptors: “depression” and “antidepressant agents” or “antidepressants” and “physical exercise”. Results. The selected studies revealed no significant differences in the therapeutic efficacy of antidepressants and physical exercise (PE) for non-severe depression. However, PE surpasses pharmacotherapy in terms of benefits for physical health, though it presents greater challenges in clinical applicability. The physiological mechanisms through which PE acts on depression have not yet been fully elucidated. Conclusions. PE demonstrates clinical outcomes comparable to pharmacotherapy, but further studies are needed to better clarify the pathways through which it exerts its effects. The practical application of this therapy is limited by various factors; therefore, patient involvement in developing the therapeutic plan is essential. Keywords. Depression; physical exercise; antidepressants