Exercise may be the most effective short-term treatment for depression in people with coronary artery disease, a new international study led by researchers at the RCSI University of Medicine and Health Sciences has found.

According to the findings, exercise was more effective compared to antidepressants, psychotherapy, or more complex care.

The study involved a review of treatment trials that investigated antidepressants, psychotherapy, exercise, combined psychotherapy and antidepressants, and collaborative care (i.e. treatments devised by a multidisciplinary team of clinicians with input from the patient).

A number of factors were assessed including the patients’ adherence to treatment, and changes in depressive symptoms eight weeks after beginning treatment.

This was the first systematic review to compare depression treatments in people with coronary heart disease. The study was also the first of its kind to establish a new method to conduct systematic reviews. Known as a hybrid review, this is a combination of umbrella reviews and systematic reviews.

It found that the strongest treatment effects were found to be exercise and combination treatments (antidepressants and psychotherapy). However, the researchers pointed out that as the results have a high risk of bias, the findings suggest that exercise is probably the most effective treatment overall.

They noted that psychotherapy and collaborative care did not perform very well.

According to the study’s first author, Dr Frank Doyle, a senior lecturer in the RCSI’s division of population health sciences, depression is common in patients with coronary artery disease, and having both conditions can have a “significant impact on the quality of life for patients”. As a result, access to effective treatments is vital.

“Our study indicates that exercise is likely to be the best treatment for depression following coronary artery disease. Our findings further highlight the clinical importance of exercise as a treatment as we see that it improves not only depression, but also other important aspects of heart disease, such as lowering blood pressure and cholesterol, in these patients,” he explained.

He noted that evidence relating to the importance of lifestyle in the treatment of disease continues to emerge, however he acknowledged that further research is needed in this area.

“People with coronary heart disease who have symptoms of depression should talk to their doctor about treatments that are most suitable for their personal needs, and clinicians can be confident of recommending exercise to their patients,” he commented.

The study also involved researchers from the UK, Denmark, the Netherlands and the US. Details are published in the journal, Psychosomatic Medicine.