Mindfulness found as effective as leading antidepressant in treating anxiety disorders

 Mindfulness-based stress reduction (MBSR) was found to be as effective as the antidepressant escitalopram in reducing agoraphobia, panic disorder, generalized anxiety disorder, and social anxiety disorder symptoms. The muti-institution study, led by the National Institute of Mental Health in Bethesda, Maryland, suggests that mindfulness practices may offer a viable alternative to medication for treating anxiety disorders, with significantly fewer side effects.

Anxiety disorders affect millions of people and are frequently treated with medications like selective serotonin reuptake inhibitors (SSRIs). While SSRIs can be an effective tool in countering the symptoms of anxiety disorders, they also come with side effects that can negatively impact a patient's quality of life in other ways.

In the case of escitalopram (sold as Lexapro and Cipralex), these adverse effects include nausea, headaches, dry mouth, excessive sweating, insomnia and fatigue.

The research team previously demonstrated that eight weeks of mindfulness-based stress reduction (MBSR) was non-inferior to escitalopram in providing stress relief and emotional regulation without having additional drawbacks.

In a new research letter, "Mindfulness Meditation vs Escitalopram for Treatment of Anxiety Disorders: Secondary Analysis of a Randomized Clinical Trial," published in JAMA Network Open, the team presents the secondary outcomes of patient-reported anxiety, depression, and quality of life from the previous study.

The study involved 276 adults diagnosed with various anxiety disorders (including agoraphobia, panic disorder, generalized anxiety disorder, and social anxiety disorder). Participants were randomly assigned to either the MBSR program or escitalopram treatment. The MBSR group attended weekly sessions focused on mindfulness meditation techniques, while the escitalopram group received dosages ranging from 10 to 20 mg per day with regular clinical follow-ups.

Researchers used multiple standardized scales to measure anxiety, depression, and quality of life, both from patient and clinician perspectives. Blinded evaluators conducted assessments using tools like the Beck Anxiety Inventory and the PROMIS Anxiety Short Form.

Findings revealed that both groups experienced similar reductions in anxiety symptoms over the study period. No significant differences were detected between MBSR and escitalopram in overall anxiety reduction by week 8, the study's primary endpoint. Escitalopram showed a slight edge in symptom reduction at the midtreatment point (week 4), but these improvements were not sustained by the end of the study.

Adverse event rates were the only significant difference between the two treatments. Nearly 79% of escitalopram recipients reported at least one study-related side effect, compared to just 15% of those in the mindfulness group.

The findings lend greater support for the use of mindfulness-based stress reduction as a reliable treatment for anxiety disorders with fewer risks, making a compelling case for its broader application in clinical settings.

More information: Hiroe Hu et al, Mindfulness Meditation vs Escitalopram for Treatment of Anxiety Disorders, JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.38453

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