Antidepressant Drugs and Physical Activity: A Possible Synergism in the Treatment of Major Depression?

Abstract

Major depressive disorder (MDD) is a severe mental illness that affects 5-20% of the general population. Current antidepressant drugs exert only a partial clinical efficacy because approximately 30% of depressed patients failed to respond to these drugs and antidepressants produce remission only in 30% of patients. This can be explained by the fact that the complex pathophysiology of depression has not been completely elucidated, and treatments have been mainly developed following the "monoaminergic hypothesis" of depression without considering the key role of other factors involved in the pathogenesis of MDD, such as the role of chronic stress and neuroinflammation. Chronic stress acts as a risk factor for the development of MDD through the impairment of neurotrophins signaling such as brain-derived neurotrophic factor (BDNF) and transforming-growth-factor-β1 (TGF-β1). Stress-induced depressive pathology contributes to altered BDNF level and function in MDD patients and, thereby, an impairment of neuroplasticity at the regional and circuit level. Recent studies demonstrate that aerobic exercise strongly increases BDNF production and it may contribute as a non-pharmacological strategy to improve the treatment of cognitive and affective symptoms in MDD. Here we will provide a general overview on the possible synergism between physical activity and antidepressants in MDD. Physical activity can synergize with antidepressant treatment by rescuing neurotrophins signaling in MDD patients, promoting neuronal health and recovery of function in MDD-related circuits, finally enhancing pharmacotherapeutic response. This synergism might be particularly relevant in elderly patients with late-life depression, a clinical subgroup with an increased risk to develop dementia.

Dopamine Multilocus Genetic Profile, Spontaneous Activity of Left Superior Temporal Gyrus, and Early Therapeutic Effect in Major Depressive Disorder

“…Major depressive disorder (MDD) is of increasing importance due to its high incidence, recurrence, disability, and burden ( 1 ). The overall remission rate of MDD is only about 70% ( 2 ). The first-line treatment strategy recommended for MDD is drug treatment, and the most commonly used in a clinical setting are selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-noradrenalin reuptake inhibitors (SNRIs) ( 3 ).…”

Associação entre o fator neurotrófico derivado do encéfalo (BDNF) e o transtorno depressivo: uma revisão de literatura

“…Não só Guerrera et al (2020), como também Kurdi e Flora (2019), Colucci-D'Amato, Speranza e Volpicelli (2020) e Gökçe, Güneş e Nalçaci (2019), avaliaram a influência da atividade física na depressão. Guerrera, et al 2020, fornece uma visão geral sobre o possível sinergismo entre atividade física e antidepressivos no TDM.…”

“…Não só Guerrera et al (2020), como também Kurdi e Flora (2019), Colucci-D'Amato, Speranza e Volpicelli (2020) e Gökçe, Güneş e Nalçaci (2019), avaliaram a influência da atividade física na depressão. Guerrera, et al 2020, fornece uma visão geral sobre o possível sinergismo entre atividade física e antidepressivos no TDM. A atividade física pode agir em conjunto com o tratamento antidepressivo ao resgatar a sinalização de neurotrofinas em pacientes com TDM, promover melhora da saúde neuronal e recuperação da função em circuitos relacionados ao transtorno, além de aumentar a resposta farmacoterapêutica.…”

Psychosocial Impact and Role of Resilience on Healthcare Workers during COVID-19 Pandemic

“…Ducan and colleagues [15] found high posttraumatic stress disorder, and extreme anxiety and depressive symptoms in healthcare workers. Different researchers found positive correlations between gender and anxiety and depressive symptoms, showing higher levels of anxiety in females [16][17][18][19]. Finally, alternative approaches have involved telemedicine [20,21], which can swiftly leverage massive volumes of providers and furnish clinical services when emergency rooms are overcrowded, cutting down the risk of infection.…”