A standardized mindfulness-based stress-reduction course was noninferior to escitalopram in one anxiety trial
Adults with diagnosed anxiety disorders improved similarly after an eight-week MBSR course or escitalopram. Nearly 80% in the medication group reported a study-related adverse event, with some withdrawals, versus about 15% and no adverse-event withdrawals in MBSR. This was a structured course, not an arbitrary meditation app.
What it takes
Course fees, 8 weeks of weekly classes and daily home practice. Sustaining daily practice takes effort.
What you may gain
A noninferiority randomized trial at 3 US urban academic centers allocated 276 adults with anxiety disorders 1:1 to eight-week MBSR or flexible-dose escitalopram 10–20 mg. Two hundred eight completed. Clinician-rated Clinical Global Impression–Severity scores fell 1.35 versus 1.43; the between-group difference was −0.07, 95% CI −0.38 to 0.23, P=0.65. The lower confidence bound remained within the prespecified noninferiority margin of −0.495. Study-related adverse events occurred in 78.6% with medication, with 10 withdrawals, versus 15.4% with mindfulness and no withdrawals for those events.
Context & considerations
The intervention was standardized eight-week MBSR, not interchangeable with any app. Participants met anxiety-disorder diagnostic criteria; clinical assessment remains appropriate. If fear of medication adverse effects has delayed treatment, this is a supported option to discuss.
Research & references
Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM (2023). Mindfulness-based stress reduction vs escitalopram for the treatment of adults with anxiety disorders: a randomized clinical trial. JAMA Psychiatry, 80(1), 13-21. https://doi.org/10.1001/jamapsychiatry.2022.3679