Positive Health Online

Abstract

HU and COLLEAGUES,  (1)Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.; (2)Medstar Health Research Institute, Hyattsville, Maryland. (3)Department of Psychiatry, Georgetown University Medical Center, Washington, DC. (4)Department of Psychiatry, NYU Grossman School of Medicine, New York; (5)Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. (6)Caen University Hospital, University of Caen Normandy, Caen, France performed an analysis of a Randomized Clinical Trial of Mindfulness Meditation vs Escitalopram for Treatment of Anxiety Disorders

Background

Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), have shown efficacy for anxiety disorders. We previously demonstrated that 8 weeks of MBSR was noninferior to escitalopram for treatment of anxiety disorders in a fully powered, multisite, noninferiority parallel-group randomized clinical trial with a predetermined margin. We present secondary outcomes of the trial, including patient-reported anxiety, depression, and quality of life (QOL).

Methodology

The trial included community-dwelling adults with a primary anxiety disorder (agoraphobia, panic, generalized anxiety, or social anxiety disorder) diagnosed by a clinician before 1:1 randomization. The MBSR intervention comprised weekly classes that included theory and practice of several forms of mindfulness meditation. Escitalopram recipients met with a prescriber at baseline and at weeks 1, 2, 4, 6, 8, and 12 and were flexibly dosed (10-20 mg/d). Local institutional review boards approved the trial protocol , and patients provided informed consent. The CONSORT reporting guideline was followed.

Results

This analysis included 276 participants (207 women [75%] and 69 men [25%]; mean [SD] age, 33 [13] years) . Participants identified as Asian (51 [19%], Black (40 [15%]), Hispanic (25 [9%]), White (166 [60%]), or other race or ethnicity (19 [6%]). No significant between-group differences in demographic characteristics or baseline outcome measures were observed, except for BAI scores.

Conclusion

This secondary analysis of a randomized clinical trial assesses patient-reported anxiety, depression, and quality of life among patients receiving mindfulness-based stress reduction vs escitalopram for the treatment of anxiety disorders. Conflict of interest statement: Conflict of Interest Disclosures: In the past 3 years, Dr Simon reported receiving grants from the National Institutes of Health (NIH), American Foundation for Suicide Prevention, Patient-Centered Outcomes Research Institute (PCORI), Ananda Scientific and support from Cohen Veterans Network and MindMed; receiving personal fees from Genomind, Cerevel; receiving fees or royalties from Wiley (Deputy Editor Depression and Anxiety), Wolters Kluwer (UpToDate), and APA Publishing; and having spousal stock from G1 Therapeutics and Zentalis outside the submitted work. Dr Bui reported receiving grants from PCORI and a private donor during the conduct of the study. In addition, Dr Bui reported receiving grants from Réseau d’Intérêt Normandie and the University Hospital Center of Caen, receiving royalties from Springer and Wolters Kluwer Health, and receiving consulting fees from Cerevel Therapeutics outside the submitted work. Dr Hoge reported receiving grants from PCORI during the conduct of the study. No other disclosures were reported.

References

Hu H(1), Mete M(2), Rustgi NK(3), Washington CI(3), Sanghavi K(2), Dutton MA(3), Simon NM(4), Baker AW(5), Bui E(6), Hoge EA(3). Mindfulness Meditation vs Escitalopram for Treatment of Anxiety Disorders: Secondary Analysis of a Randomized Clinical Trial.  JAMA Netw Open.;7(10):e2438453. doi: 10.1001/jamanetworkopen.2024.38453. Oct 1 2024