Mindfulness works as well as an anxiety drug in a new study

Manxiety meditation worked as well as standard anxiety medication in the first head-to-head comparison.

The study tested a widely used mindfulness program that included 2 1/2 hours of classes per week and 45 minutes of daily practice at home. Participants were randomly assigned to the program or daily use of a generic drug sold under the brand name Lexapro for depression and anxiety.

After two months, anxiety, as measured by a severity scale, decreased by about 30% in both groups and continued to decrease over the next four months.

Research results, published Wednesday in the magazine JAMA Psychiatry, are timely. In September, an influential US health task force recommended routine screening for anxiety in adults, and numerous reports suggest that global anxiety levels have increased recently, linked to worries about the pandemic, political and racial unrest, climate change and financial uncertainty.

Anxiety disorders include social anxiety, generalized anxiety, and panic attacks. Affected individuals are troubled by persistent and intrusive worries that interfere with their lives and relationships. In the U.S., anxiety disorders affect 40 percent of U.S. women at some point in their lives and more than 1 in 4 men, according to data cited in the U.S. Preventive Services Task Force’s screening recommendations.

Mindfulness is a form of meditation that emphasizes focusing only on what is happening in the moment and rejecting intrusive thoughts. Sessions often begin with breathing exercises. The next might be “body scan” — thinking about each part of the body systematically, from head to toe. When anxious thoughts intrude, participants learn to briefly acknowledge them but then dismiss them.

Instead of dwelling on the anxious thought, “you say, ‘I have this thought, let it go for now,'” said lead author Elizabeth Hodge, director of Georgetown University’s Anxiety Disorders Research Program. With practice, “It changes the relationship people have with their own thoughts when they’re not meditating.”

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Previous studies have shown that mindfulness works better than no treatment, or at least as well as education or more formal behavioral therapy, in reducing anxiety, depression and other mental health problems. But this is the first study to test it against a psychiatric drug, Hodge said, and the results could make insurers more willing to cover the costs, which can reach $300 to $500 for an 8-week session.

The results are based on about 200 adults who completed the six-month study at medical centers in Washington, Boston and New York. The researchers used a psychiatric scale of 1 to 7, with the highest number reflecting severe anxiety. The average score was about 4.5 for the participants before starting treatment. It dropped to about 3 at two months, then fell slightly in both groups at three months and six months. Hoge said the change was clinically meaningful, leading to a noticeable improvement in symptoms.

Ten patients on the drug dropped out due to unpleasant side effects, possibly related to the treatment, which included insomnia, nausea and fatigue. There were no dropouts for this reason in the mindfulness group, although 13 patients reported increased anxiety.

Dr. Scott Krakower, a psychiatrist at Zucker Hillside Hospital in New York, said mindfulness treatments often work best for mildly anxious patients. He prescribes them with medication for patients with more severe anxiety.

He noted that many people feel they don’t have time for mindfulness meditation, especially in-person sessions like the ones studied. It is not known whether similar results would be found with online training or phone apps, said Krakower, who was not involved in the study.

Olga Cannistraro, a freelance writer in Keene, New Hampshire, participated in an earlier mindfulness study led by Hoge and says it taught her to “interfere with my own state of mind.”

During a session, just admitting she felt tension all over her body helped her calm down, she said.

Cannistraro, 52, has generalized anxiety disorder and has never taken medication for it. She was a single mother working in sales at the time of this earlier study — circumstances that made life particularly stressful, she said. She has since gotten married, changed jobs, and feels less anxious, although she still uses mindfulness techniques.

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