Harvard Mental Health Letter

In Brief: Mindfulness may rival medication at preventing depression relapse

Depression is often a chronic condition marked by alternating periods of remission and relapse. To increase chances of long-term remission, clinicians usually recommend that patients remain on some type of maintenance therapy — usually an antidepressant — for extended periods. But not everyone wants to take medications indefinitely, and some — notably pregnant women or people taking other drugs — may have good reason not to. One study suggests a possible alternative to maintenance medication: mindfulness-based therapy.

Researchers in Canada conducted a randomized controlled study involving 160 adult patients who had experienced at least two episodes of major depression. In the first phase of the study, the patients took antidepressants. Most took selective serotonin reuptake inhibitors (SSRIs), but those who did not obtain adequate relief from an SSRI were offered another type of drug.

After eight months, 84 participants (53% of the total) achieved remission and progressed to the 18-month maintenance phase of the study. During this phase, they were randomly assigned to one of three arms: continued use of their antidepressant medication at a lower dose; gradual tapering to a placebo pill and clinical management; or gradual tapering to mindfulness-based therapy.

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