Does Antidepressant Use Blunt Adaptations to Exercise?

Study Overview
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Brief Summary
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Nearly one out of ten US adults over the age of 18 currently takes antidepressant medication, which can also treat other conditions such as anxiety. Combining pharmaceutical treatment with exercise may yield even greater benefits than using drugs alone, and this is commonly prescribed for depression. However, little is known about the drug-exercise interactions and their influence on metabolic health. A common side effect of antidepressant use is weight gain, particularly abdominal (visceral) fat, which is highly detrimental to overall health. Exercise is a well-known counter to abdominal fat accumulation. The aim of the proposed study is to compare the efficacy of 6 weeks of exercise training to reduce abdominal fat in healthy overweight/obese adults either taking or not taking antidepressant medication. Twenty-four inactive overweight/obese, but otherwise healthy, adults will complete 6 weeks of an exercise training intervention consisting of three days of aerobic exercise training per week. Participants will either not be taking antidepressant medication or will have been on their medication for at least 1 year. The primary outcome will be abdominal fat determined by waist circumference and dual x-ray absorptiometry, which is considered one of the optimal methods for assessment of abdominal fat.

Official Title
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Do Antidepressant Medications Blunt Responses to Exercise Training in Overweight and Obese Individuals?

Conditions
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Depression, Depressive Disorder, Metabolic Syndrome

Intervention / Treatment
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* Behavioral: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants will be English language speakers Male or females between the ages of 18-40. All genders and ethnicities. Healthy as assessed by a health history questionnaire (no diagnosed physical diseases or conditions preventing participation in exercise). Individuals on antidepressants will be recruited if they are consuming selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) only. Participants will send prescription information after consent has been provided as part of the screening process, including the dose and frequency of medication. A body mass index (BMI) of 25 or greater is required for inclusion. Exclusion Criteria: Inability to complete moderate-vigorous exercise. Taking first generation antidepressant medications or other medications such as monoamine oxidase inhibitors (MAOI). Other medications, such as medications for attention-deficit hyper-activity disorder or metabolism Undiagnosed depression that may be unveiled during the screening process.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>This arm will consist of healthy overweight and obese individuals who are physically inactive and do not have clinically diagnosed depression or depression symptoms. | Behavioral: Exercise<br>* The intervention consists of 180 minutes of moderate-vigorous aerobic exercise per week for 6 weeks.<br>|
| Experimental: Antidpressants<br>This arm will consist of healthy overweight and obese adults who are physically inactive and who are diagnosed with clinical depression and have been taking antidepressant medications for at least 1 year. | Behavioral: Exercise<br>* The intervention consists of 180 minutes of moderate-vigorous aerobic exercise per week for 6 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visceral adipose tissue (VAT) | VAT assessed by dual-energy X-ray absorptiometry (DXA) | Change from baseline after 6 weeks. | 
| Waist circumference | Waist circumference is a proxy of VAT | Change from baseline after 6 weeks. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Aerobic fitness | Fitness assessed via a maximal treadmill exercise test | Change from baseline after 6 weeks. | 
| Blood pressure | Resting blood pressure assessed with an oscillatory blood pressure monitor | Change from baseline after 6 weeks. | 
| Blood glucose | Fasting capillary glucose sample | Change from baseline after 6 weeks. | 
| Blood lipid panel | Fasting capillary blood sample for triglycerides and cholesterol | Change from baseline after 6 weeks. | 
| Body mass | Body mass measured on a scale | Change from baseline after 6 weeks. | 
| Fat mass | Total and segmental body fat mass measured by DXA | Change from baseline after 6 weeks. | 
| Lean mass | Total and segmental lean mass measured by DXA | Change from baseline after 6 weeks. | 
| Dietary intake | Food logs recorded over two week days and one weekend day | Change from baseline after 6 weeks. | 
| Physical activity | Free-living physical activity assessed over 7 days via combined heart-rate and accelerometry | Change from baseline after 6 weeks. | 
| Depression symptoms | Symptoms of depression assessed with Beck's Depression Inventory (BDI). The BDI is a 21-item questionnaire that measures total depressive symptoms. Individual item scores range from 0-3. Individual items are then summed to provide a total score, ranging from 0 to 63. | Change from baseline after 6 weeks. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise, Antidepressants, Visceral fat