Exercise may reduce depressive symptoms, according to a Cochrane review.

A 2026 republication of a Cochrane review analyzed 73 randomized trials with nearly 5,000 adults and found that exercise can reduce depressive symptoms and may show similar effects to psychological or pharmacological treatments in some small trials.

A Cochrane review republished in 2026 examined whether exercise affects depressive symptoms in adults. The review pooled 73 randomized controlled trials that enrolled almost 5,000 people with depression, and 69 trials contributed data to the analysis. Researchers compared exercise with other active interventions such as psychological therapies and pharmacological treatments. The goal was to measure depressive symptoms at the end of treatment and, where available, at longer-term follow-up. Key findings: - The review included 73 randomized controlled trials and nearly 5,000 participants; 69 trials provided data for analysis. - Ten trials (414 participants) compared exercise with psychological therapy and found little to no difference in depressive symptoms at the end of treatment, with similar findings at longer follow-up. - Five trials (330 participants) compared exercise with pharmacological treatment and reported little to no difference at the end of treatment; evidence for long-term effects was very uncertain. - The review concluded that exercise could reduce depressive symptoms and may be moderately more effective than control interventions in some trials. - Researchers highlighted limitations such as small trial sizes and limited long-term follow-up, and called for higher-quality studies to identify which exercise types and components help which people and why. - The review and accompanying discussion note possible mechanisms including changes in neurotransmitters and hormones (for example serotonin, endorphins, dopamine, adrenaline, noradrenaline), improved sleep and self-esteem, and potential benefits from outdoor activity. Summary: The review indicates that exercise can reduce depressive symptoms and, in several small trials, showed effects similar to psychological or pharmacological treatments. Researchers say trial quality needs improvement and further research is required to determine which forms and doses of exercise work for different people and to clarify long-term outcomes.