• HidalgoJesús López-TorresJLAlbacete Zone VIII Health Center, Albacete, Spain jesusl@sescam.org.Faculty of Medicine, University of Castile-La Mancha, Albacete, Spain., Joseba Rabanales Sotos, and DEP-EXERCISE Group.
• Albacete Zone VIII Health Center, Albacete, Spain jesusl@sescam.org.
• Ann Fam Med. 2021 Jul 1; 19 (4): 302309302-309.

PurposeWe sought to compare the effectiveness of physical exercise with that of treatment with antidepressant drugs routinely used in clinical practice, in terms of decreasing depressive symptomatology in patients aged ≥65 years who present with clinical criteria of a depressive episode.MethodsWe conducted a randomized clinical trial in a primary care setting. A total of 347 patients aged ≥65 years with a clinically significant depressive episode were randomized to participation in a supervised physical exercise program or to receive antidepressant treatment by their general practitioners.ResultsIntention-to-treat analysis showed that the cumulative incidence of improvement in depressive symptomatology (Montgomery-Åsberg Depression Rating Scale score <10) in the physical activity (PA) group after 1 month was not significantly different from that in the antidepressant treatment (AT) group. However, the proportion of those who showed improvement was significantly greater (P <.01) in the AT group (60.6% and 49.7%) compared to the PA group (45.6% and 32.9%) at the end of 3 and 6 months, respectively. The number of withdrawals was greater in the PA group (39.2% and 58.2%) compared to the AT group (22.6% and 40.0%) at 3 and 6 months, respectively, yet the proportion of participants with adverse side effects was greater in the AT group (8.9% vs 22.5%; P = .007).ConclusionAlthough improvement was initially similar in both treatment groups, AT was superior in the medium term, despite giving rise to a greater number of adverse effects.© 2021 Annals of Family Medicine, Inc.

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