Over the past twenty years, an extensive body of research shows that mindful meditation is an effective treatment for a variety of mental health disorders, including anxiety, but surprisingly, very little research compares mindfulness meditation with medication, which is the standard, first-line treatment for most anxiety disorders.
A study published in October 2024 called “Mindfulness Meditation vs Escitalopram for Treatment of Anxiety Disorders” fills this research void by examining the impact of mindful meditation and escitalopram – widely known by its commercial name, Lexapro – on symptoms of anxiety, depression, and quality of life among people diagnosed with agoraphobia, panic, generalized anxiety, or social anxiety disorder.
About the Study: Mindfulness Meditation and Medication
Mindful meditation is well-known. The basic idea is that mindfulness helps us become completely aware of our thoughts, feelings, and physical sensations in the present moment, without trying to judge or change them: we learn to observe our thoughts and feelings and let them run their course without unconsciously reacting or overacting to them.
In that way, mindful meditation helps people with anxiety and other mental health disorders manage their symptoms by giving them tools to experience their feelings without being controlled by them: mindfulness gives them choice – and it has no side effects at all.
Escitalopram, a.k.a. Lexapro, is also well-known, but as an antidepressant medication. It’s in a class of medications called selective serotonin reuptake inhibitors (SSRIs) commonly prescribed to reduce the symptoms of depression and anxiety by increasing the amount of serotonin – a neurotransmitter associated with positive mood – circulating in the brain. However, escitalopram is also associated with significant side effects, including sexual problems, nausea, diarrhea, insomnia, constipation, and others.
That’s one very compelling reason for studies like this one: escitalopram can reduce symptoms for many people, but many people aren’t willing to risk the side effects, and are unhappy with the side effects when they do appear.
Let’s take a look at the results of the study.
Meditation or Medication for Anxiety and Depression
The research team recruited a total of 276 adults and divided them into two groups. One group participated in mindfulness mediation classes once a week for 12 weeks, while the other group met with a prescriber and received medication once a week for 12 weeks. All study participants completed questionnaires or received assessments at baseline – the start of the study – and once a week for 24 weeks.
Standard scales for anxiety, worry, panic, depression, and quality of life formed the core of data collection for the study. Researchers understood that both mindfulness and medication are both effective treatments for anxiety and other mental health disorders. To determine their relative effectiveness, the research team compared the size of the improvements associated with each treatment approach.
Here’s what they found, based on a comparison of assessments administered at baseline and the end of the six-week study.
Mindfulness or Medication: Does One Work Better Than the Other?
Beck Anxiety Inventory:
- Escitalopram showed slightly greater symptom reduction than MBSR
PROMIS (Patient-Reported Measurement Information System) Anxiety Short Form:
- No statistical difference between mindfulness and medication in reduction of anxiety symptoms
Penn State Worry Questionnaire:
- No statistical difference between mindfulness and medication in reduction of frequency and duration of worry/worrying symptoms
Liebowitz Social Anxiety Scale:
- No statistical difference between mindfulness and medication in reduction of anxiety symptom
Panic Disorder Severity Scale:
- No statistical difference between mindfulness and medication in reduction of frequency and severity of panic symptoms
Depression scale (PROMIS):
- No statistical difference between mindfulness and medication in reduction of depressive symptoms
Satisfaction With Participation in Social Roles Scale (PROMIS):
- No statistical difference between mindfulness and medication in improvement in participation satisfaction with social roles
Ability to Participate in Social Roles and Activities Scale (PROMIS):
- No statistical difference between mindfulness and medication in improvement in ability to participate in social roles/activities
As we can see, mindfulness was as effective as medication for reducing anxiety symptoms on all scales and metrics aside from the Beck Anxiety Inventory. Findings here include measures of depression and quality of life, which show that mindfulness is as effective as medication in improving quality of life in social roles and activities.
How This Research Helps
There are many reasons people don’t seek treatment for mental health disorders such as anxiety and depression. Stigma around mental health disorders and treatment for mental health disorders is still strong, but that’s not the only thing that keep people away. Fear of side the side effects of medication, particularly when those side effects include decreased libido and various other sexual problems, also prevent people from seeking treatment.
They may know they have anxiety or depression, but don’t want to risk taking medication that impacts their sex life. That’s why this news about mindful meditation is important.
Here’s how the researchers describe the results of the study:
“These findings support clinical application of MBSR to treat anxiety disorders, with outcomes similar to antidepressant pharmacotherapy but with potentially fewer side effects.”
We’re encouraged by this study, because mindful meditation can be a very powerful tool in mental health treatment. It’s inexpensive, easy to learn, and once you learn it, the skills are yours for life. In addition – as the research team observes – mindful meditation has “potentially fewer side effects” than traditional medication such as escitalopram.
