Many people who experience a bout of anxiety or depression will experience recurrent episodes or relapses. Prescription antidepressants are the traditional line of treatment for overcoming a depressive episode and staving off relapses but they come with side effects that many people cannot tolerate. The effects of these drugs are of particular concern during pregnancy and breastfeeding because any drug the mother takes is passed along to the baby.

New research indicates chemical-free mindfulness-based cognitive therapy (MBCT) might be the solution when antidepressant medications prove too risky or the side effects are too difficult to sustain. The study’s findings revealed MBCT was equally effective as antidepressant prescription drugs in preventing relapse over a 24-month period, produced no toxic or other ill effects, and cost about the same.

Dr. Willem Kuyken, of the University of Oxford’s Department of Psychiatry and the University of Exeter’s Mood Disorders Centre, both in the United Kingdom (UK), led the study comparing MBCT with antidepressant medications. His is the first formal study comparing the two in a randomized, controlled clinical trial.

Kuyken’s research team recruited 424 adult study participants from 95 general practitioner offices throughout rural and urban UK. One-half of the study participants (212 individuals) were randomly assigned for mindfulness therapy and the remaining 212 participants took antidepressants at maintenance doses for 24 months. Each participant was followed throughout the two-year study period.

How mindfulness therapy works

For this study, each member of the MBCT group attended eight group therapy sessions that lasted 2.5 hours each. Guided mindfulness practices, group discussions, and behavioral training exercises were covered in the group sessions. Participants were also coached on how to practice mindfulness outside the sessions. After the eight sessions were complete, participants were allowed to attend four more sessions over the course of a year if they so desired.

Mindfulness therapy is an evolution of ancient Eastern traditions in practice for thousands of years. It enhances the awareness and cognition of the practitioner. In the treatment of depression, MBCT enhances awareness of negative emotional spirals that could trigger relapse and cognition training that teaches the patient behavioral skills to help overcome damaging thoughts and dark moods. Kuyken describes MBCT as training the mind and body to respond constructively to negative experiences with the hope of preventing relapse into depression.

The results of the study

Although more than half the study participants experienced no relapses during the study, there were relapses in both groups:

• 44% in the MBCT group.
• 47% in the antidepressant group.

Ten serious adverse events were reported during the 24-month study, equally divided between the two groups:

• 3 non-fatal events occurred in each group.
• 2 fatal events occurred in each group.

All adverse events were reported to the UK’s Trial Steering and Data Monitoring Committees and all were deemed unrelated to the trial.

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Sources:

1. Kuyken, Willem, et al. "Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomized controlled trial." The Lancet (2015). Web. 4 May 2015.
2. "Mindfulness." Brown University Health Promotion. Brown University, n.d. Web. 4 May 2015.