Adding Chronotherapy or Exercise to Antidepressants for Major Depression

Because major depression fails to remit with pharmacotherapy in many patients, several adjunctive nonpharmacological strategies have been investigated. Now, in a 29-week randomized trial involving 75 patients with persistent major depression (mean age, 48; mean age at onset of initial episode, 33; treatment resistance, 62%), researchers have examined the effects of medication plus either “chronotherapeutics” or exercise. The current episode had lasted >2 years in 24%; 16% of participants had bipolar I or II depression and were receiving mood stabilizers.

All participants received duloxetine at 60 mg/day for the first 9 weeks, with dosage increased to ≤120 mg/day (or the antidepressant changed) during the next 20 weeks, if necessary. The chro…