The MOTAR Study: Exercise as a Path to Mental Wellness

The recent Mood Treatment with Antidepressants or Running, or MOTAR study, published in the Journal of Affective Disorders and led by Brenda Penninx, has provided valuable insights into the connection between exercise and mental health, particularly highlighting running therapy's efficacy in treating depression and anxiety disorders. This research aligns closely with the ethos of Philadelphia Integrative Psychiatry, reinforcing our commitment to holistic and integrative care by presenting running as a powerful therapeutic option for depression and anxiety. It offers patients a viable complement or alternative to traditional antidepressants, emphasizing our belief in the critical role of lifestyle and physical activity in mental health management.

Study Design and Results Breakdown

Study Overview

• The study set out to evaluate the effectiveness of SSRIs versus running therapy in enhancing the mental and physical health of patients with depression and/or anxiety disorders. Conducted as a partially randomized pragmatic trial that allowed for patient preference and lasting 16 weeks, it involved 141 participants who were, on average, 38.2 years old, with females making up 58% of the study group. The interventions tested included prescribing escitalopram, starting at 10 mg daily with the possibility of increasing to 20 mg depending on the patient's response and tolerability, with sertraline as an alternative. Additionally, running therapy consisted of supervised 45-minute outdoor running sessions, aimed at two to three times a week, following public health recommendations.

Key Findings

• The key findings revealed that the remission rates for depression and anxiety were nearly identical between the groups receiving antidepressants (44.8%) and those undergoing running therapy (43.3%), suggesting that both treatments were equally effective in improving mental health. However, when it came to physical health outcomes, those in the running therapy group experienced more favorable changes than their counterparts on antidepressants. Specifically, runners did not see significant weight changes, unlike antidepressant users who gained weight. Runners also reduced their waist circumference, while it increased in the antidepressant group. Blood pressure improved in the running group but worsened in the antidepressant group, and heart rate variability saw enhancements from running therapy, with no change observed in the antidepressant group.

Adherence and Conclusions 

• Regarding adherence and preferences, the study found that antidepressant users had a higher adherence rate (82%) compared to those in the running group (52%). Initially, a larger number of participants chose running therapy over antidepressants. The study concluded that although both treatments were equally effective for mental health, running therapy provided additional benefits for physical health. It highlighted the importance of considering patient preference and the potential of exercise as a viable treatment option for depression and anxiety, also noting the need for strategies to improve adherence to exercise-based treatments.

This concise overview of the MOTAR study underscores the dual benefits of running therapy, offering mental health improvements on par with antidepressants and superior physical health advantages, thereby reinforcing the potential of exercise as a valuable component in mental health treatment strategies.