Depression: Mindfulness therapy 'as effective as antidepressants at preventing relapse'

Mindfulness can be used as an alternative to taking antidepressants to prevent relapse, researchers have said.

The cognitive therapy has been found to be effective for people who do not want to continue long-term antidepressant treatment.

Published in the Lancet, the authors from the University of Exeter undertook the largest ever study comparing mindfulness with maintenance antidepressant medication to see if it reduced the risk of relapse.

Mindfulness was developed to help people with depression by teaching them skills to recognise and respond to thoughts and feelings associated with relapse – preventing them from going into a downward spiral. It combines techniques like meditation, breathing and yoga to help people be more aware of their bodies.

Richard Byng, study co-author, said: "Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly.

"However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects."

In the trial, 424 adults with recurrent major depression who were taking antidepressants were randomly assigned to come off their medication and receive mindfulness, or to stay on their medication.

The mindfulness group attended eight sessions and were asked to practice at home. Participants were assessed at regular intervals.

While the findings showed mindfulness is no more effective than antidepressants at preventing relapse, it showed the practice offers a similar level of protection. Relapse rates were similar in both groups – 44% in the mindfulness group and 47% in the antidepressant group.

Alison Evans, lead therapist delivering the treatment during the trial, said: "MBCT [mindfulness-based cognitive therapy] offers people with recurrent depression a way of reducing the rate of relapse. Participants in this study learnt mindfulness skills in a group setting over eight weeks with daily home practice. Mindfulness gives the awareness to recognise early signs of relapse, allowing for responses to prevent a downward spiral."

Lead author Willem Kuyken added: "While 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."