title: Exercise and pharmacotherapy in patients with major depression: one-year follow-up of the SMILE study.
abstract: OBJECTIVE
  To examine a 1-year follow-up of a 4-month, controlled clinical trial of exercise and antidepressant medication in patients with major depressive disorder (MDD).
  
  
  METHODS
  In the original study, 202 sedentary adults with MDD were randomized to: a) supervised exercise; b) home-based exercise; c) sertraline; or d) placebo pill. We examined two outcomes measured at 1-year follow-up (i.e., 16 months post randomization): 1) continuous Hamilton Depression Rating Scale score; and 2) MDD status (depressed; partial remission; full remission) in 172 available participants (85% of the original cohort). Regression analyses were performed to examine the effects of treatment group assignment, as well as follow-up antidepressant medication use and self-reported exercise (Godin Leisure-Time Exercise Questionnaire), on the two outcomes.
  
  
  RESULTS
  In the original study, patients receiving exercise achieved similar benefits compared with those receiving sertraline. At the time of the 1-year follow-up, rates of MDD remission increased from 46% at post treatment to 66% for participants available for follow-up. Neither initial treatment group assignment nor antidepressant medication use during the follow-up period were significant predictors of MDD remission at 1 year. However, regular exercise during the follow-up period predicted both Hamilton Depression Rating Scale scores and MDD diagnosis at 1 year. This relationship was curvilinear, with the association concentrated between 0 minute and 180 minutes of weekly exercise.
  
  
  CONCLUSIONS
  The effects of aerobic exercise on MDD remission seem to be similar to sertraline after 4 months of treatment; exercise during the follow-up period seems to extend the short-term benefits of exercise and may augment the benefits of antidepressant use.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00331305.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC 27710, USA. Benson.Hoffman@duke.edu
authors.forename: Benson M
authors.initials: BM
authors.lastname: Hoffman
authors.forename: Michael A
authors.initials: MA
authors.lastname: Babyak
authors.forename: W Edward
authors.initials: WE
authors.lastname: Craighead
authors.forename: Andrew
authors.initials: A
authors.lastname: Sherwood
authors.forename: P Murali
authors.initials: PM
authors.lastname: Doraiswamy
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Coons
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D020280:Sertraline / Q000627:therapeutic use*; D012944:Social Support; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D020280:Sertraline