Story at a glance
- Millions of Americans suffer from anxiety disorders.
- But access barriers and side effects prevent some from receiving effective treatment.
- For many, common antidepressant medications are ineffective.
An eight-week mindfulness meditation program is as effective as the common antidepressant escitalopram (Lexapro) at treating anxiety disorders among adults, according to new results of a randomized clinical trial.
The trial was the first of its kind to directly compare the guided mindfulness-based intervention with a first-line medication for anxiety.
“Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers,” said lead study author Elizabeth Hoge in a release.
“A big advantage of mindfulness meditation is that it doesn’t require a clinical degree to train someone to become a mindfulness facilitator. Additionally, sessions can be done outside of a medical setting, such as at a school or community center,” she continued. Hoge is director of the Anxiety Disorders Research Program and associate professor of psychiatry at Georgetown University.
Findings were published in JAMA Psychiatry and reflect data on 102 adults treated for their anxiety with a mindfulness-based stress reduction (MBSR) program and 106 patients who received 10 to 20 mg of Lexapro.
Lexapro is a selective serotonin reuptake inhibitor — a common type of antidepressant drug — that was first introduced in the late 1980s.
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Researchers assessed patients’ anxiety symptoms before and after treatment. Each group’s symptom severity dropped by around 30 percent following the intervention. On a scale of 1 to 7, those who underwent MBSR saw a 1.35 point mean reduction in symptom severity. Those treated with Lexapro reported a 1.43 point mean reduction for the drug, marking a statistically equivalent outcome.
Ten patients who were treated with Lexapro dropped out of the trial due to adverse events.
MBSR is a program that employs mindfulness meditation to alleviate suffering resulting from a variety of physical and mental disorders. The eight-week program involves “weekly 2.5-hour long classes, a day-long retreat weekend class during the fifth or sixth week, and 45-minute daily home practice exercises,” authors wrote.
“Problematic habitual thought patterns characterize anxiety disorders, and mindfulness training specifically focuses the mind on the present moment; thus, individuals practice seeing thoughts and sensations as merely transient mental phenomena and not necessarily accurate reflections of reality,” they explained.
“This reappraisal process improves emotion regulation, and individuals become less reactive to thoughts and sensations. In addition, mindfulness is practiced with a nonjudgmental, accepting attitude, which over time appears to increase self-acceptance and self-compassion.”
Around 7 million Americans suffer from generalized anxiety disorder, while only 43 percent of patients receive treatment. Although drugs prescribed for anxiety can be effective in some patients, many face access barriers, don’t respond to the treatments, or find the side effects too burdensome.
This year, the United States Preventive Services Task Force recommended all adults under the age 65 undergo routine anxiety screening.
Study participants were recruited from three hospitals in New York City, Boston and Washington, D.C., between June 2018 and February 2020. Mean patient age was 33 and the majority were women.
“It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect,” Hoge added.
“Virtual delivery via videoconference is likely to be effective, so long as the ‘live’ components are retained, such as question-and-answer periods and group discussion.”
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