Can regular physical exercise be a treatment for panic disorder? A systematic review

ABSTRACT

Introduction

In the last few decades, exercise has been explored as a potential tool to reduce symptoms experienced by patients with panic disorder (PD). This systematic review aims to assess the effects of regular exercise interventions on panic severity, global anxiety, and depression symptoms of these patients.

Areas covered

A search was conducted on PubMed, ISI Web of Science, and Cochrane Central Register of Controlled Trials using search terms related to PD and exercise. Eight trials were included, Furthermore, regular exercise programs presented different methodological characteristics. There is o clear evidence indicating that regular exercise programs (at least two 20-minute sessions per week for at least 6 weeks) reduce panic-related symptoms. Regular exercise is effective in improving global anxiety measures and depression.

Expert opinion

Continuous aerobic exercise is the main type of intervention in the literature, generally providing a limited prescription. Currently, it is recommended the interval training, with intense and shorter stimuli, and long-term duration trials. However, despite the use of self-selected intensities and control based on the internal load be interesting as recommendation to increase adherence, careful is needed regarding training prescription due to scarce evidence.

KEYWORDS:

• Anxiety
• exercise
• depression
• panic attack
• panic disorder

Article highlights

• Regular exercise seems to be effective to improve PD symptoms; however, this is still not clear;

• Comorbidities, such as depression, are positively affected by the effects of exercise;

• Patients with PD should be encouraged to practice regular physical exercise for health promotion;

• Exercise prescription based on self-selected and controlled intensities according to the internal physiological load can be adequate routes for adherence to regular exercise;

• New randomized controlled studies need to be carried out to determine state-of-the-art practices when using exercise for PD, allowing for better standardization of intervention and more adequate control groups.

Declaration of interests

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

S Machado was supported by grant from Carlos Chagas Foundation for the Research Support in the State of Rio de Janeiro (FAPERJ), E −26/203.295/2017.