A University of Oxford-led randomized controlled study published in The Lancet found that mindfulness-based cognitive therapy was as effective as antidepressants at preventing relapses in depressed people. The press release for the study noted this also meant that MBCT “isn’t any more effective” than maintenance antidepressant treatment in preventing relapses. However, the mindfulness group had to deal with another important confounding factor which the study authors only noted in passing.
The study involved 424 patients with a history of recurrent depression. Over 2 years, nearly half of the people in both the mindfulness group and the antidepressant group had relapsed (44% in the MBCT group vs 47% in the maintenance antidepressant medication group).
The authors stated that, “(W)hen considered in the context of the totality of randomised controlled data, we found evidence from this trial to support [mindfulness-based cognitive therapy] as an alternative to maintenance antidepressants for prevention of depressive relapse or recurrence at similar costs.”
The authors noted one limitation of the study was that the sample “consisted of a group of people at high risk of depressive relapse or recurrence.” The authors also noted — but did not factor into their evaluations of the results — that the entire group that were in the mindfulness arm had been taking antidepressants for some time and had to withdraw from them for the study. The authors described offering “support” for tapering, but did not include any information about how long the participants had been taking antidepressants for and how rapidly they came off them.
Other studies recently reported by Mad in America have found that withdrawal effects from antidepressants can be severe and long lasting and cause relapses.
Mindfulness-based therapy could offer an alternative to antidepressants for preventing depression relapse (The Lancet press release on ScienceDaily, April 20, 2015)
Kuyken, Willem, Rachel Hayes, Barbara Barrett, Richard Byng, Tim Dalgleish, David Kessler, Glyn Lewis, 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 Randomised Controlled Trial.” The Lancet. Accessed April 27, 2015. doi:10.1016/S0140-6736(14)62222-4. (Abstract and full text)