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Exercise as an add-on strategy for the treatment of major depressive disorder: A systematic review

机译：锻炼作为治疗重度抑郁症的附加策略：系统评价

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Antidepressants are currently the treatment of choice for major depressive disorder (MDD). Nevertheless, a high percentage of patients do not respond to a first-line antidepressant drug, and combination treatments and augmentation strategies increase the risk of side effects. Moreover, a significant proportion of patients are treatmentresistant. In the last 30 years, a number of studies have sought to establish whether exercise could be regarded as an alternative to antidepressants, but so far no specific analysis has examined the efficacy of exercise as an adjunctive treatment in combination with antidepressants. We carried out a systematic review to evaluate the effectiveness of exercise as an adjunctive treatment with antidepressants on depression. A search of relevant papers was carried out in PubMed/Medline, Google Scholar, and Scopus with the following keywords: "exercise," "physical activity," "physical fitness," "depressive disorder," "depression," "depressive symptoms," "add-on," "augmentation," "adjunction," and "combined therapy." Twenty-two full-text articles were retrieved by the search. Among the 13 papers that fulfilled our inclusion criteria, we found methodological weaknesses in the majority. However, the included studies showed a strong effectiveness of exercise combined with antidepressants. Further analyses and higher quality studies are needed; nevertheless, as we have focused on a particular intervention (exercise in adjunction to antidepressants) that better reflects clinical practice, we can hypothesize that this strategy could be appropriately and safely translated into real-world practice.
机译：目前，抗抑郁药是重度抑郁症（MDD）的治疗选择。尽管如此，仍有很大比例的患者对一线抗抑郁药无反应，并且联合治疗和增强策略会增加副作用的风险。此外，很大一部分患者对治疗有抵抗力。在过去的30年中，许多研究试图确定运动是否可以被视为抗抑郁药的替代品，但是到目前为止，尚无任何具体分析检查运动作为抗抑郁药的辅助治疗的功效。我们进行了系统的评价，以评估运动作为抗抑郁药辅助治疗的有效性。在PubMed / Medline，Google Scholar和Scopus中搜索了相关的论文，关键词如下：“锻炼”，“身体活动”，“身体健康”，“抑郁症”，“抑郁”，“抑郁症状”， ”，“附加项”，“增强项”，“附加项”和“综合治疗”。通过搜索检索了22篇全文文章。在满足我们纳入标准的13篇论文中，我们发现了大多数方法论上的不足。但是，纳入的研究表明运动与抗抑郁药联合使用具有很强的效果。需要进一步的分析和高质量的研究;但是，由于我们将重点放在更好地反映临床实践的特定干预措施（与抗抑郁药相结合的锻炼）上，因此我们可以假设该策略可以适当且安全地转化为现实世界的实践。

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