Mindfulness meditation vs escitalopram for anxiety

Mindfulness meditation has been shown to have various mental health benefits. For example, a review of 13 studies showed improvement in ADHD symptoms with mindfulness meditation (1).

Also, 41 trials show mindfulness meditation helped improve stress related outcomes such as anxiety, depression, stress, positive mood, etc. (2)

A review of 14 clinical trials shows meditation being more effective than relaxation techniques for anxiety (3).

A recent study looked at whether mindfulness based stress reduction (MBSR) was as effective as an anti-anxiety medication Lexapro (escitalopram) (4).

Who was in the study? (4)

  • 102 participants in MBSR and 106 participants in the escitalopram group, with a mean age of 33 years (4).
  • Participants were mostly female (4).

How was anxiety measured (4)?

  • Clinical Global Impression of Severity scale (CGI-S) was performed by blinded clinical interviewer at baseline, week 8 end point, and follow-up visits at 12 and 24 weeks (4).
  • Primary patient reported measure was the Overall Anxiety Severity and Impairment Scale (OASIS) (4).

What was the intervention? (4)

  • Participants were randomized 1:1 to 8 weeks of the weekly MBSR course or the antidepressant escitalopram, flexibly dosed from 10 to 20 mg (4).
  • MBSR group was taught MBSR as a manualized 8-week protocol with 45 minute daily home practice exercises, weekly 2.5-hour long classes, a day-long retreat weekend class during the fifth or sixth week (5).
  • Participants were taught several forms of mindfulness meditation, such as breath awareness (focusing attention on the breath and other physical sensations), a body scan (directing attention to one body part at a time and observing how that body part feels), and mindful movement (stretching and movements designed to bring awareness to the body and increase interoceptive awareness) (4,5).

What were the results? (4)

Participants who completed the trial at week 8 showed noninferiority for CGI-S score improvement with MBSR compared with escitalopram (4)—meaning MBSR was as effective as escitalopram.

What are some caveats?

  • This is the first study to compare MBSR to medication (4).
  • The study did not use commonly used instruments to measure anxiety in clinical settings such as GAD-7, Hamilton rating scale for anxiety or the Beck anxiety inventory, etc.
  • Participants had any anxiety disorder, not a specific type of anxiety disorder such as generalized anxiety disorder, panic disorder etc (4) which make it difficult to generalize results for other populations.
  • Participants (4) were mostly female in the 30’s which makes it difficult to generalize results for other populations.
  • MBSR is a specific type of manualized meditation taught by qualified instructors (5) and it may be difficult to find qualified instructors or qualified classes in your area.
  • In addition to work, school, and life obligations, people may find it difficult to schedule 45 minutes of daily meditation plus 2.5 hours of weekly class plus a day long retreat.
  • Different people may benefit from different types of meditation, and this area is being further researched.
  • Practicing meditation regularly may lead to improved benefits, and some people may see benefits with shorter duration of meditation.
  • Some people may find that mindfulness or too much mindfulness may worsen their symptoms (6), so you should check with your mental health professional if MBSR is appropriate for you.
  • Some mental health conditions may not be appropriate for MBSR, check with your mental health professional.

Want to learn more about meditation?

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By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.


  1. Poissant, H., Mendrek, A., Talbot, N., Khoury, B., & Nolan, J. (2019). Behavioral and Cognitive Impacts of Mindfulness-Based Interventions on Adults with Attention-Deficit Hyperactivity Disorder: A Systematic Review. Behavioural neurology2019, 5682050. doi:10.1155/2019/5682050
  2. Goyal M, Singh S, Sibinga EMS, et al. Meditation Programs for Psychological Stress and Well-Being [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Jan. (Comparative Effectiveness Reviews, No. 124.)Available from: https://www.ncbi.nlm.nih.gov/books/NBK180102/
  3. Montero-Marin, J., Garcia-Campayo, J., Pérez-Yus, M., Zabaleta-del-Olmo, E., & Cuijpers, P. (n.d.). Meditation techniques v. relaxation therapies when treating anxiety: A meta-analytic review. Psychological Medicine,1-16. doi:10.1017/S0033291719001600
  4. Hoge, Elizabeth A et al. “Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial.” JAMA psychiatry, e223679. 9 Nov. 2022, doi:10.1001/jamapsychiatry.2022.3679
  5. Santorelli  SF, Kabat-Zinn  J, Blacker  M, Meleo-Meyer  F, Koerbel  L. Mindfulness-Based Stress Reduction (MBSR) Authorized Curriculum Guide. Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Revised 2017. Accessed December 14, 2017. https://www.bangor.ac.uk/mindfulness/documents/mbsr-curriculum-guide-2017.pdf
  6. Britton, W. B., Lindahl, J. R., Cooper, D. J., Canby, N. K., & Palitsky, R. (2021). Defining and Measuring Meditation-Related Adverse Effects in Mindfulness-Based Programs. Clinical Psychological Science9(6), 1185–1204. https://doi.org/10.1177/2167702621996340

Meditation might grow the brain, literally.

Meditation grows your brain picWith the the most recent semester in rear view and next semester coming up, it may be a time to reflect on ways to improve yourself for a better semester and a better you.

Have you considered the many benefits of meditation and/or yoga?

Studies show that mindfulness-based meditation can be helpful for anxiety (1), depression (2), substance abuse (3), eating disorders (4), and improve your sense of well-being and quality of life (5).

College students might have another reason to meditate: it could grow your brain.

In 2 different studies, meditation increased the size of brain regions called the hippocampus (6-7) and the insula (6) (8). This might help with academic performance since these regions are involved in learning (9), memory (9), emotional control (10), for the insula, the process of awareness (11).

In another study (12), participants who practiced an average 27 minutes of mindfulness meditation (MBSR) daily over 8 weeks, had increased concentration of grey matter in brain regions involved in learning, memory processes, emotional regulation, and other processes.

With all these benefits, is it time for you to give meditation a try? Can it help you feel better, or make you a better student? How do you know?


On-campus resources:

  • The RPAC offers a number of Yoga classes each week throughout the semester.  Check their group fitness schedule for the latest.
  • CCS offers a weekly meditation workshop, called KORU specifically designed for college students.  Workshops will resume at the start of the semester.
  • Meditation groups and Mindfulness Based Stress Reduction programs happen all over campus- look for them in the new semester!

Online resources for meditation:



A special thanks to my colleagues Jennifer Lang, MA, LSW, MSW, for suggesting a study and Abbey Carter-Logan, MA, PACC-S, for the edits.


This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes.  With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.



  1. Roemer, L., Orsillo, S.M., Salters-Pedneault, K., 2008. Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology 76, 1083–1089.
  2. Teasdale, J.D., et. al, 2000. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 68, 615–623.
  3. Bowen, S., et.al , 2006. Mindfulness meditation and substance use in an incarcerated population. Psychology of Addictive Behaviors 20, 343–347.
  4. Tapper, K., et. al. 2009. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite 52, 396–404.
  5. Carmody, J., Baer, R.A., 2008. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine 31, 23–33.
  6. Hölzel, B.K.,  et. al. 2008. Investigation of mindfulness meditation practitioners with voxel-based morphometry. Social Cognitive and Affective Neuroscience 3, 55–61.
  7. Luders, E., Toga, A.W., Lepore, N., Gaser, C., 2009. The underlying anatomical correlates of long-term meditation: larger hippocampal and frontal volumes of gray matter. Neuroimage 45, 672–678.
  8. Lazar, S.W., Kerr, C.E., Wasserman, R.H., Gray, J.R., Greve, D.N., Treadway, M.T., McGarvey, M., Quinn, B.T., Dusek, J.A., Benson, H., Rauch, S.L., Moore, C.I., Fischl, B., 2005. Meditation experience is associated with increased cortical thickness. Neuroreport 16, 1893–1897.
  9. Squire, L.R., 1992. Memory and the hippocampus: a synthesis from findings with rats,monkeys, and humans. Psychological Review 99, 195–231.
  10. Corcoran, K.A., Desmond, T.J., Frey, K.A., Maren, S., 2005. Hippocampal inactivation disrupts the acquisition and contextual encoding of fear extinction. Journal of Neuroscience 25, 8978–8987.
  11. Craig, A.D., 2009. How do you feel — now? The anterior insula and human awareness. Nature Reviews Neuroscience 10, 59–70.
  12. Holzel BK, et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging 191 (2011) 36–43.