Mindfulness as effective and cheaper than antidepressants, study finds

Mindfulness therapy is just as effective as antidepressants in preventing a relapse of depression, a study has found.

Consultation: mindfulness alternative to antidepressants
Consultation: mindfulness alternative to antidepressants

Mindfulness-based cognitive therapy (MBCT), teaches patients skills to help them identify when they are at risk of depression and how to prevent a relapse.

The researchers say MBCT could be an alternative for people who do not want to continue taking antidepressant medication, for example because of side effects.

It is also ‘relatively low cost’ compared to medication, the authors say in the study in The Lancet.

New choice

As part of the study, 424 adults with recurrent major depression were split into two groups: one that continued to take 'maintenance' medication, and one that eased off it and received MBCT.

Those in the MBCT group attended eight sessions that were over two hours long, consisting of guided mindfulness practices, group discussion and other cognitive behavioural exercises.

During the two-year follow-up, relapse rates were 44% in the MBCT group and 47% in the antidepressant group.

‘Whilst this study doesn’t show that mindfulness-based cognitive therapy works any better than maintenance antidepressant medication in reducing the rate of relapse in depression, we believe these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions,' said lead author Professor Willem Kuyken from the University of Oxford.

Important mainstay

Dr Andrew Green, chair of the clinical and prescribing subcommittee of the GPC, said the option of MBCT would be useful for some patients, but some would continue to choose antidepressants.

‘As ever, the skill is in matching the patient to the medication,’ he told GP.

‘It is good that there does appear to be an additional treatment available to prevent relapse in this vulnerable group, for patients who have problems with or concerns about maintenance antidepressant therapy. Many patients do prefer talking therapies but individual work is simply beyond the budgets of many mental health services.

‘What should also be noted, at a time when GPs face criticism for antidepressant prescribing, is that maintenance treatment does remain an important mainstay of treatment.’

In an accompanying comment article, Professor Roger Mulder from the University of Otago in New Zealand said: ‘It might be feasible to offer [mindfulness-based cognitive therapy] as a choice to patients in general practice’ because it is cost-effective and can be used to treat a large group of patients at one time.

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