Research Update

November 22, 2022 by

Mindfulness-Based Stress Reduction Versus Medication for the Treatment of Anxiety Disorders

Anxiety disorders are common. They can be highly distressing and interfere with functioning.  Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), can decrease anxiety, but it has not been known how they compare to other treatments, including medications.

The purpose of this randomized trial was to determine if MBSR was as effective as escitalopram, a medication commonly used to treat anxiety disorders.  A total of 276 adults with a diagnosed anxiety disorder were recruited for the trial, and 208 completed it.  Participants were randomized to eight weeks of the weekly MBSR course or escitalopram, at a dose of 10 to 20 mg daily. The primary outcome measure was anxiety level as assessed with the Clinical Global Impression of Severity scale (CGI-S) performed at baseline, week 8 end point, and follow-up visits at 12 and 24 weeks.  The scale is rated from 1 (not at all ill) to 7 (most extremely ill).

The sample had a mean age of 33 years and 75% were female. Baseline mean CGI-S score was 4.49 for the MBSR group and 4.54 for the escitalopram group. At the end of the study, the mean CGI-S score was 3.09 for MBSR and 3.09 for escitalopram. This change was within the bounds established to show that MBSR was not inferior to escitalopram.  The benefits persisted equally for both groups at 24 weeks. A total of 10 (8%) patients dropped out of the escitalopram group and none from the MBSR group due to adverse events. At least one study-related adverse event occurred for 110 participants randomized to escitalopram (78.6%) and 21 participants randomized to MBSR (15.4%).

The results of this study suggest that MBSR can be as effective as escitalopram for the treatment of anxiety disorders and is associated with fewer adverse events.

Hoge EA, Bui E, Mete M, et al. AMA Psychiatry. Published online November 9, 2022

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