1. Comparison of Exercise and Antidepressants on Treatment of Major Depressive Disorder
Shannon Laratonda
University of Pittsburgh
December 14, 2009
Research and Sports Science
Dr. Elizabeth Nagle

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Literature Review
Depression is a major disorder that affects one’s well being. Depression is a common
cause of morbidity and mortality worldwide (6). Studies to evaluate the association between
exercise and depression are important in providing the option of having alternative ways of
reducing their symptoms besides antidepressants.
Research analyzing this association between exercise and depression included Menzyk et.
al. who found physically active obese women had significantly better judgment concerning the
looks of their faces, breasts, legs, and height compared to physically inactive ones. This suggests
positive self-esteem effects level of depression (1). Smits et. al. found a positive effect and
supports exercise prescription for treatment of anxiety sensitivity. This suggests that using
exercise to reduce anxiety sensitivity leads to significant improvements in levels of anxiety and
depressed mood (2). De Moor et. at. confirmed in a longitudinal study of twin adults that lower
levels of regular exercise are associated with higher levels of anxious and depressive symptoms
(3). Comparatively, Bartholomew et. al. investigated that a 30 minute bout of moderate-intensity
aerobic exercise sufficiently improves mood and well-being in patients with major depressive
disorder (4). Similar to previous studies, Blumenthal et. al. studied the efficacy of exercise in
patients with major depressive disorder and found it to be generally comparable with patients
receiving antidepressant medication (5).
Medications often have an infinite number of unwanted and irritable side-effects causing
a vicious cycle of being prescribed more and more to cover up other symptoms, putting
individuals at risk for drug addiction. As an ideal treatment, exercise has minimal irritable side-
effects such as muscle soreness and has many health benefits such as reducing risk of CVD and

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diabetes, decreasing emotional tension and external stresses, increasing self-esteem and
counteracts depression.
The purpose of this study is to show how exercise serves as a better treatment than
antidepressants in patients diagnosed with major depressive disorder. Antidepressants can be
very dangerous with severe side=effects and become addicting. A lifestyle containing regular
physical activity and exercise is much healthier to become addicted to. Exercise has many other
positive effects outside improvement of depression. Physical activity serves to reduce the risk of
hypertension, diabetes, coronary heart disease, obesity, hyperglycemia, and other cardiovascular
diseases as well as improving well-being.
Ho: Exercise is not more beneficial than antidepressants in treating major depressive disorder.

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Methods
I. Type of Research Design and Sample Size and Sampling Method
a. 100 subjects diagnosed with major depressive disorder (MDD) recruited from
institutions like Western Psychiatric Hospital, ages 18+, male and female
b. 4 groups: exercise only; antidepressants only; exercise and antidepressants; and
placebo serving as control group
c. Test pre- and post- exercise/antidepressants after 6 month period using
questionnaires and clinical interviews with a specified psychologist
d. Subjects rights and privacy will be protected by HIPAA and informed consent
will be obtained from each subject
II. Methodology
a. Screening of individuals will be done to eliminate subjects with any disorder on
top of major depressive disorder (>1 disorder)
b. Study will obtain approval by Dr. Elizabeth Nagle et. al. of University of
Pittsburgh Research Review Board
c. Group 1 and 3 will perform supervised 30 minutes of moderate-intensity aerobic
exercise in Trees gym 4-5 times a week for 6 months (any convenient time)
d. Group 2 and 3 will be prescribed monthly doses of antidepressants for 6 months
e. Group 4 will receive placebo for 6 months
f. All groups will receive interview and questionnaires 1 week before start of
exercise and/or medication
g. Human Subjects

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i. Following recruitment procedures, potential subjects would typically be
contacted. This proposal serves strictly for the achievement of gained
knowledge and experience with research among undergraduate students.
The following proposal will not be submitted for publication.
Confidentiality will be strictly enforced and data will not be collected. No
portion of this proposal used publicly, therefore Human Subject Review is
unnecessary.
III. Statistical Analysis
a. Independent variables: questionnaires and psychiatric interviews measuring
severity of MDD
b. Dependent variables: exercise, antidepressant, placebo
c. SPSS to run descriptive statistics to compare groups: correlation between exercise
and medication, z-scores, dependent T-test (pre- and post-)
d. Any p value ≤.05 will be considered statistically significant and will result in
rejection of null

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REFERNCES
1. Menzyk K, Cajdler A, Pokorski M. Influence of Physical Activity on Psychosomatic Health
in Obese Women. Journal of Physiology and Pharmacology. 2008;6:441-448.
2. Smits AJ, Berry AC, Rosenfield D, Powers MB, Behar E, Otto MW. Reducing Anxiety
Sensitivity with Exercise. Depression and Anxiety. 2008;25:689-699.
3. De Moor MH Boomsma DI, Stubbe JH, Willemsen G, DeGeus JC. Testing Causality in the
Association Between Regular Exercise and Symptoms of Anxiety and Depression. Arch Gen
Psychiatry. 2008;8:897-905.
4. Bartholomew JB, Morrison D, Ciccolo JT. Effects of acute exercise on mood and well-being
in patients with major depressive disorder. Medicine & Science in Sports & Exercise.
2005;37:2032-2037.
5. Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA,
Herman S, Craighead WE, Brosse AL, Waugh R, Hinderliter A, and Sherwood A. Exercise
and Pharmacotherapy in the Treatment of Major Depressive Disorder. Psychosomatic
Medicine. 2007;69:587-596.
6. Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for
depression. The Cochrane Collaboration. 2009;4.