INTRODUCTION: Major depressive disorder is frequent and implies a high morbimortality. The addition of exercise has been proposed to improve the response rate to pharmacological monotherapy. However, this intervention is still controversial. METHODS: We searched Epistemonikos, the largest database of systematic reviews in health, maintained by screening multiple sources of information, including Medline/PubMed, Embase, and Cochrane. We extracted data from the identified reviews, analyzed the data from the primary studies, performed a meta-analysis, and prepared a summary table of the results using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. RESULTS AND CONCLUSIONS: We identified 20 systematic reviews that together included 15 primary studies. Of these, eight were randomized trials. We con-clude that the addition of aerobic exercise to pharmacological monotherapy for patients with major depression could slightly decrease the severity of depressive symptoms with low certainty of evidence.

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