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Mindfulness Practice Found as Effective as Escitalopram for Reducing Anxiety in Adults
Mindfulness-based stress reduction (MBSR) has “comparable effectiveness” to first-line medication treatment for easing anxiety disorders in adults, according to new research published in JAMA Psychiatry.
The findings were shared shortly after the US Preventive Services Task Force recommended routinely screening for anxiety in adults amid reports that anxiety rates have increased around the world.
“Effective treatments for anxiety disorders exist and include medications and cognitive behavioral therapy, but not all patients have access to them, respond to them, or are comfortable seeking care in a psychiatric setting,” said Elizabeth A. Hoge, MD, Department of Psychiatry, Georgetown University Medical Center, Washington, DC, and co-authors. “These challenges support a need for additional evidence-based treatment options for patients with anxiety disorders with broad acceptability.”
The first randomized clinical trial to compare MBSR directly to escitalopram included 276 adults diagnosed with an anxiety disorder from 3 hospitals in Boston, New York City, and Washington, DC. Patients were randomly assigned to 8 weeks of a weekly MBSR course or to the antidepressant medication, administered flexibly from 10 to 20 mg.
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Patient response was measured using the Clinical Global Impression of Severity scale (CGI-S) from 1 (not at all anxious) to 7 (among the most extremely anxious), with evaluations conducted at baseline, mid-treatment, end point, and follow-up at weeks 12 and 24.
At 8 weeks, CGI-S scores showed that MBSR was noninferior when compared with escitalopram. The MBSR group score improved by a mean (SD) 1.35-point reduction and the escitalopram group by 1.43-point reduction. Overall, then, both groups experienced an approximately 30% drop in the severity of their anxiety.
“Although replication in different settings is warranted, this study’s finding of the noninferiority of MBSR to a first-line pharmacotherapy for treatment of anxiety provides support for mindfulness meditation as an evidence-based treatment option for adults with anxiety disorders,” the authors concluded.
The second phase of the study, conducted during the COVID-19 pandemic, examined MBSR administered virtually via videoconference, and will be the focus of future analyses.
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