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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jrbecker on November 11, 2003, at 19:23:15
nothing new of course, but just more evidence to show that this combo works...
SFN: Exercise Boosts Drug Treatment for Depression
By Roberta Friedman, PhDNEW ORLEANS, LA -- November 10, 2003 -- Exercise significantly decreased symptoms of depression in people already taking commonly prescribed drugs for the problem, according to research at the University of Texas Southwest Medical Center in Dallas, presented here today at the Society for Neuroscience 33rd Annual Meeting.
Study investigator Tracy Greer, PhD, of the Center's psychiatry department, said, "one of the biggest challenges in treating depression, is [that] people are left with residual symptoms. Drugs have an effect, they just don't have enough of an effect."
A common strategy these days is for physicians to add another drug, Dr. Greer said. "Unlike with adding another medication, adding exercise reduces the risk of bothersome side effects," she explained. Exercise adds health benefits as well, Dr. Greer noted.
The investigators studied 17 patients, with an average age of 39 years. The patients had residual symptoms despite taking either selective serotonin reuptake inhibitors or venlafaxine extended release. Participants cited such continuing problems as insomnia, inability to concentrate, sadness, and irritability.
The subjects' age at onset of depression averaged 25 years. Major depression was confirmed by the structured clinical interview for the Axis I disorders, classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Treatment with medication was established for 1 to 9 months prior to study entry. Patients were sedentary or exercising less than 3 days a week.
Exercise included treadmill, walking, or cycling for 12 weeks, with at least 30 minutes spent on the activity for most days of the week. The exercise prescribed was the equivalent of 17.5 kcal per kg per week. Clinicians and patients rated symptoms every week.
The Hamilton Rating Scale provided the physician-rated outcome, while the Inventory for Depressive Symptomatology served as the patients' self-report vehicle. Hamilton scores fell from a mean of 17.4 at baseline, to 7.0 at week 12 (P < .05). Self-rating scores also fell significantly, from 34.8 at baseline to 12.9 at week 12. Intent-to-treat analyses also demonstrated statistically significant improvements for both ratings.
A larger study is underway.
[Study Title: Exercise as an augmenting treatment for major depressive disorder: A pilot study. Abstract 851.9.]
Posted by Ilene on November 12, 2003, at 15:51:13
In reply to Exercise Boosts Drug Treatment for Depression, posted by jrbecker on November 11, 2003, at 19:23:15
Exercise didn't do it for me. It can make things worse for people with cfs or fibromyalgia.
Ilene
Posted by SLS on November 13, 2003, at 12:44:11
In reply to Re: Exercise Boosts Drug Treatment for Depression, posted by Ilene on November 12, 2003, at 15:51:13
> Exercise didn't do it for me. It can make things worse for people with cfs or fibromyalgia.
>
> IleneIt doesn't help me either. One of my former doctors, Baron Shopsin, felt that intense exercise like weight-lifting depleted brain
amines, and should be avoided. I am not convinced of that, though.- Scott
Posted by jrbecker on November 13, 2003, at 22:17:49
In reply to Exercise Boosts Drug Treatment for Depression, posted by jrbecker on November 11, 2003, at 19:23:15
Both from the research and from my own experience, I'm fairly certain that consistent moderate-to-intense exercise is one of the most effective -- if not the best -- antidepressant treatment available. I have been a long-distance runner for years, and it's my saving grace when it comes to staving off my atypical depression. To me, meds are just the icing on the cake comparably to exercise. Combingin both means treatments has kept me out of the abyss.
> nothing new of course, but just more evidence to show that this combo works...
>
>
>
> http://www.docguide.com/news/content.nsf/news/8525697700573E1885256DDA00754B72?OpenDocument&id=21A9EF972BF43CEA85256D600052DD73&c=Depression&count=10
>
> SFN: Exercise Boosts Drug Treatment for Depression
> By Roberta Friedman, PhD
>
> NEW ORLEANS, LA -- November 10, 2003 -- Exercise significantly decreased symptoms of depression in people already taking commonly prescribed drugs for the problem, according to research at the University of Texas Southwest Medical Center in Dallas, presented here today at the Society for Neuroscience 33rd Annual Meeting.
>
> Study investigator Tracy Greer, PhD, of the Center's psychiatry department, said, "one of the biggest challenges in treating depression, is [that] people are left with residual symptoms. Drugs have an effect, they just don't have enough of an effect."
>
> A common strategy these days is for physicians to add another drug, Dr. Greer said. "Unlike with adding another medication, adding exercise reduces the risk of bothersome side effects," she explained. Exercise adds health benefits as well, Dr. Greer noted.
>
> The investigators studied 17 patients, with an average age of 39 years. The patients had residual symptoms despite taking either selective serotonin reuptake inhibitors or venlafaxine extended release. Participants cited such continuing problems as insomnia, inability to concentrate, sadness, and irritability.
>
> The subjects' age at onset of depression averaged 25 years. Major depression was confirmed by the structured clinical interview for the Axis I disorders, classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Treatment with medication was established for 1 to 9 months prior to study entry. Patients were sedentary or exercising less than 3 days a week.
>
> Exercise included treadmill, walking, or cycling for 12 weeks, with at least 30 minutes spent on the activity for most days of the week. The exercise prescribed was the equivalent of 17.5 kcal per kg per week. Clinicians and patients rated symptoms every week.
>
> The Hamilton Rating Scale provided the physician-rated outcome, while the Inventory for Depressive Symptomatology served as the patients' self-report vehicle. Hamilton scores fell from a mean of 17.4 at baseline, to 7.0 at week 12 (P < .05). Self-rating scores also fell significantly, from 34.8 at baseline to 12.9 at week 12. Intent-to-treat analyses also demonstrated statistically significant improvements for both ratings.
>
> A larger study is underway.
>
>
> [Study Title: Exercise as an augmenting treatment for major depressive disorder: A pilot study. Abstract 851.9.]
>
>
Posted by SLS on November 14, 2003, at 8:29:05
In reply to Re: Exercise Boosts Drug Treatment for Depression, posted by jrbecker on November 13, 2003, at 22:17:49
> Both from the research and from my own experience, I'm fairly certain that consistent moderate-to-intense exercise is one of the most effective -- if not the best -- antidepressant treatment available.
Perhaps for you. Not for me.
- Scott
Posted by Kacy on November 14, 2003, at 19:20:52
In reply to Re: Exercise Boosts Drug Treatment for Depression, posted by SLS on November 14, 2003, at 8:29:05
Exercise never makes me feel better. I feel better about myself if I am in shape, but the exercise itself doesn't do anything positive for me in terms of making me feel better. I've done plenty of it to know, including a full-hour of Super Advanced Aerobics. (No short, 50-minute hour for us, and we got our stretching done before class.) Those 3 x a week classes were only half my exercise schedule.
I read an explanation for that in a profile for inattentive Add. The exercise high is from dopamine and, of course, Adders are short on the ability to make dopamine–even from exercise. Another point made was that we made muscles easily. Reading that gave me one of those "Oh, my God" moments. I had always said that I make muscles like a man. I try not to give other women exercise advice because of that. I realized a long time ago that they couldn't develop muscle anywhere near as quickly as me.
Below is another piece that I saw recently. It's a study on kids. It says that they didn't get a dopamine increase after exercise like the controls, and that they only got one-third the norepinephrine increase the controls got.
Reading this study made me sad. I don't like to think about it, even though I've always known. I'd like to call up an old therapist and tell her not to tell everyone they'll feel better if they exercise. She kept saying that. Never worked for me. Think twice before you tell people what exercise will do for them.
Catecholamine Response to Exercise in Children with Attention Deficit Hyperactivity Disorder.Pediatr Res 2003 Mar 5; [epub ahead of print]
"The objective of this study was to examine differences in catecholamine (CA) response to exercise between children who had received a diagnosis of attention-deficit/hyperactivity disorder (ADHD) and age- and sex-matched controls. On the basis of the notion of a CA dysfunction in ADHD, we reasoned that the normal robust increase in circulating CA seen in response to exercise would be blunted in children with ADHD. To test this, we recruited 10 treatment-naive children with newly diagnosed ADHD and 8 age-matched controls (all male) and measured CA response to an exercise test in which the work was scaled to each subject's physical capability. After exercise, epinephrine and norepinephrine increased in both control and ADHD subjects (p = 0.006 and p = 0.002, respectively), but the responses were substantially blunted in the ADHD group (p = 0.018) even though the work performed did not differ from controls. Circulating dopamine increased significantly in the control subjects (p < 0.016), but no increase was noted in the subjects with ADHD. Finally, a significant attenuation in the lactate response to exercise was found in ADHD (between groups, p < 0.005). Our data suggest that CA excretion after exercise challenges in children with ADHD is deficient. This deficiency can be detected using a minimally invasive, nonpharmacologic challenge." [Abstract]
Can anyone tell me what this means? …"a significant attenuation in the lactate response to exercise was found in ADHD."
Posted by Ilene on November 15, 2003, at 11:59:57
In reply to Catecholamine Response to Exercise, posted by Kacy on November 14, 2003, at 19:20:52
> Below is another piece that I saw recently. It's a study on kids. It says that they didn't get a dopamine increase after exercise like the controls, and that they only got one-third the norepinephrine increase the controls got.
>
> Reading this study made me sad. I don't like to think about it, even though I've always known. I'd like to call up an old therapist and tell her not to tell everyone they'll feel better if they exercise. She kept saying that. Never worked for me. Think twice before you tell people what exercise will do for them.
>
>
> Catecholamine Response to Exercise in Children with Attention Deficit Hyperactivity Disorder.
>
> Pediatr Res 2003 Mar 5; [epub ahead of print]
> "The objective of this study was to examine differences in catecholamine (CA) response to exercise between children who had received a diagnosis of attention-deficit/hyperactivity disorder (ADHD) and age- and sex-matched controls. On the basis of the notion of a CA dysfunction in ADHD, we reasoned that the normal robust increase in circulating CA seen in response to exercise would be blunted in children with ADHD. To test this, we recruited 10 treatment-naive children with newly diagnosed ADHD and 8 age-matched controls (all male) and measured CA response to an exercise test in which the work was scaled to each subject's physical capability. After exercise, epinephrine and norepinephrine increased in both control and ADHD subjects (p = 0.006 and p = 0.002, respectively), but the responses were substantially blunted in the ADHD group (p = 0.018) even though the work performed did not differ from controls. Circulating dopamine increased significantly in the control subjects (p < 0.016), but no increase was noted in the subjects with ADHD. Finally, a significant attenuation in the lactate response to exercise was found in ADHD (between groups, p < 0.005). Our data suggest that CA excretion after exercise challenges in children with ADHD is deficient. This deficiency can be detected using a minimally invasive, nonpharmacologic challenge." [Abstract]
>
>
> Can anyone tell me what this means? …"a significant attenuation in the lactate response to exercise was found in ADHD."
>I know lactic acid builds up in muscles during exercise--I think it's the end product of one of the energy-producing metabolic cycles--but I'm sure Larry Hoover or someone else who actually remembers their biochem can tell us for sure. Must be related to "lactate response". Now you've got me curious and I will have to do a web search.
Exercise never did anything for me and I never built much muscle. I think I'm just physiologically abnormal because my blood pressure drops and I probably can't get enought oxygen to my muscles when exercise. I also resent all the advice I got or read about, because I can't do any of it without becoming more impaired.
About this study: my guess is they took blood samples and looked at CAs circulating through the *body*. Aren't the CAs in the brain the ones of interest? Is there a correlation? I thought that was one of the problems with diagnosing and treating depression--you couldn't do a simple blood test and determine that a person had low levels of norepinephrine or whatever.
Ilene
Posted by Mid- Life Crisis on November 15, 2003, at 15:30:52
In reply to Re: Exercise Boosts Drug Treatment for Depression, posted by jrbecker on November 13, 2003, at 22:17:49
It is well known that there are many health benefits to regular exercise, and who is to say that an increase in brain chemicals completely explains why most people feel better (depressed or not) after becoming acclimated to a regular exercise program. I have ADHD and always felt much better after I exercised (unless it had been a while since I'd exercised, then it just made me tired.) However, now that I'm on Strattera, I find I can't get energized from exercise, or while exercising, like I always could before. Perhaps the increased norephinephrine in the brain caused by the Strattera interferes with this??)
Anyhow, it stands to reason that if you feel good physically (as after a workout) you will have less tendency to be depressed, whether taking an antidepressant or not. On the other hand, not exercising always causes me to feel "blah", and it is much easier to become depressed in that state than when feeling energized. In addition, fatigue from exercising also tends to make sleep easier/better quality. Adequate sleep also helps fight depression.
Researchers looking only at brain chemicals miss the big picture, the all-important "mind-body" connection.
Posted by Kacy on November 17, 2003, at 0:14:58
In reply to Re: Catecholamine Response to Exercise, posted by Ilene on November 15, 2003, at 11:59:57
Thanks, Ilene. If you find anything, I hope you'll post it.
Mid-life crisis: the good feeling after exercising comes from the chemicals. They aren't there for all of us after exercising. I think it might be hard to understand. I got an exercise high once a long time ago. I know what it can feel like.
If you mean that keeping your body healthy because exercise helps your bones and heart, etc. and being healthy leaves you feeling better than illness, then yes.
Posted by john1022 on November 17, 2003, at 9:49:47
In reply to Re: Catecholamine Response to Exercise » Ilene, posted by Kacy on November 17, 2003, at 0:14:58
I am pretty sure the good feelings one gets after exercise is more related to endophine release more so than an increase in catecholamine response or increase serotonin/NE. although who knows, maybe they both work hand in hand. but when you get a massage and feel good afterwards, almost like a little high, that is all endorphines which makes me believe it is endorphines being released when you exercise that gives you the good feeling
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