Section - Quick Takes

05. The Antidepressant Effects of Exercise: A Proposed Framework

Published on February 1, 2025 Certification expiration date: February 1, 2028

Derick E. Vergne, M.D.

Assistant Professor - Tufts University School of Medicine

Key Points

Exercise may decrease inflammation and boost dopamine transmission, potentially improving depression and increasing motivation.
Exercise could decrease inflammation and alter brain circuitry involved in decision making and reward processing in depressed individuals.
Prescribing exercise should be tailored on a case-by-case basis, considering both the potential benefits and risks for each patient.

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Exercise Alleviates Depression: Proposed Mechanisms

Today, I discuss a hypothesis-driven paper in which the authors reference multiple lines of evidence from animal and clinical studies.

They propose that exercise relieves depression by altering dopaminergic networks and reducing inflammation. Specifically, they suggest that exercise decreases systemic inflammation, enhances dopamine transmission, and improves the experience of pleasure associated with motivation.

The antidepressant effects of exercise are well established, but not fully understood.

Depression Linked to Dopamine and Inflammation

Utilizing multiple lines of evidence, the authors proposed the following points:

Depression is associated with disruptions in dopamine transmission
Disrupted dopamine transmission is associated with changes in reward processing and motivation
Generalized inflammation has been associated with depression
Both depression and inflammation are associated with disrupted dopamine transmission in brain areas known to process reward and reward saliency

The authors cited studies connecting depression to reduced activity in cortical regions responsible for conscious, rational

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Table of Contents

Learning Objectives:

After completing this activity, the learner will be able to:

Describe the relationship between clozapine dose/plasma levels and obsessive-compulsive symptoms in patients with schizophrenia.
Explain the dose-dependent relationship between valproate and weight gain.
Compare the relative efficacy of aripiprazole, brexpiprazole, and cariprazine as adjunctive treatments for treatment-resistant depression.
Evaluate the evidence linking delirium to increased risk of dementia.
Identify evidence-based psychosocial and pharmacological treatment approaches for stimulant use disorder.

Original Release Date: February 1, 2025

Expiration Date: February 1, 2028

Experts: Scott Beach, M.D., Paul Zarkowski, M.D. & Derick Vergne, M.D.

Medical Editors: Flavio Guzmán, M.D. & Sebastián Malleza M.D.

Relevant Financial Disclosures:
None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.