TL;DR
An updated Cochrane review of 73 randomized trials finds regular physical activity reduces depressive symptoms about as effectively as psychological therapy and shows similar effects to antidepressants, though the latter comparison is less certain. Light to moderate exercise across multiple sessions produced the biggest gains, with few reported harms.
What happened
Researchers leading an updated Cochrane systematic review pooled evidence from 73 randomized controlled trials involving nearly 5,000 adults diagnosed with depression to compare exercise with no treatment, psychological therapy and antidepressant medication. Overall, exercise produced moderate reductions in depressive symptoms relative to no treatment. When set against psychological therapies, exercise yielded similar improvements based on moderate-certainty evidence drawn from ten trials. Comparisons between exercise and antidepressant drugs suggested comparable effects, but the evidence for that was judged to be of low certainty. Programs of light to moderate intensity activity delivered over multiple sessions (roughly 13–36 sessions) were linked to larger symptom changes. Reported adverse events were uncommon; exercise-related issues were mainly muscle or joint injuries, while medication groups experienced typical drug-related effects. The review authors noted that many trials were small and that few studies included longer-term follow-up, limiting conclusions about durability.
Why it matters
- Exercise is a low-cost, widely accessible option that also offers physical health benefits, making it an appealing treatment component for many people with depression.
- Findings suggest exercise can be an alternative or complement to psychological therapy for some patients, potentially expanding treatment choices where access to therapy is limited.
- The safety profile in trials was generally favorable, with few reported adverse events tied to exercise programs.
- Uncertainty about long-term effects and optimal exercise prescriptions means clinicians and patients need better evidence to guide sustained use and personalization.
Key facts
- The review included 73 randomized controlled trials with nearly 5,000 adult participants diagnosed with depression.
- Exercise produced moderate reductions in depressive symptoms compared with no treatment or control conditions.
- Against psychological therapy, exercise showed similar improvements based on moderate-certainty evidence from ten trials.
- Comparisons between exercise and antidepressant medication suggested similar benefits, but the certainty of that evidence was low.
- Light to moderate intensity activity across multiple sessions (about 13–36 sessions) was associated with larger symptom improvements.
- Programs combining different activity types and including resistance training appeared more effective than aerobic exercise alone in the trials reviewed.
- Adverse events were uncommon; exercise groups reported occasional muscle or joint injuries while medication groups reported fatigue and gastrointestinal issues.
- The update added 35 new trials to earlier reviews, but many individual studies remained small and few provided long-term follow-up data.
What to watch next
- Larger, higher-quality randomized trials designed to identify which exercise types work best for which patient groups
- Research that tracks participants for longer after treatment to determine how durable exercise benefits are over time
- Evaluation of specific activities not covered in this review (for example, yoga or qigong) to establish their effectiveness
Quick glossary
- Randomized controlled trial (RCT): A study design that randomly assigns participants to different interventions to compare outcomes and reduce bias.
- Psychological therapy: Structured treatments provided by trained practitioners that use psychological methods to treat mental health conditions.
- Antidepressant medication: Drugs prescribed to treat depressive disorders by altering brain chemistry; effectiveness and side effects vary by class and individual.
- Light-to-moderate intensity exercise: Physical activity that raises heart rate and breathing somewhat but still allows conversation; examples include brisk walking or gentle cycling.
- Resistance training: Exercise that uses external resistance, such as weights or bodyweight, to build muscle strength and endurance.
Reader FAQ
Should people with depression replace therapy or medication with exercise?
Not confirmed in the source. The review suggests exercise can help some people and may perform similarly to therapy in trials, but it does not state that exercise should replace other treatments for all patients.
What type and amount of exercise seemed most effective?
Trials linked light to moderate intensity activity across roughly 13–36 sessions with larger improvements; combined programs including resistance work appeared more effective than aerobic-only programs.
Are the benefits of exercise for depression long-lasting?
Long-term effects are unclear because few studies in the review included extended follow-up.
Were there safety concerns with exercise in these trials?
Reported harms were uncommon; exercise groups occasionally reported muscle or joint injuries, while medication groups experienced typical drug-related effects like fatigue and gastrointestinal symptoms.
Who conducted the review?
The Cochrane review was led by researchers at the University of Lancashire and authored by a team including Professor Andrew Clegg.
Science News from research organizations Scientists find exercise rivals therapy for depression A growing body of evidence suggests that moving your body might lift depression nearly as well as therapy—no…
Sources
- Exercise can be nearly as effective as therapy for depression
- Exercise to treat depression yields similar results to therapy …
- Exercise for depression – Clegg, AJ – 2026
- Exercise may relieve depression as effectively as …
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