When anxiety gets in the way of life, a mindfulness-based stress reduction course works no worse than the commonly used anti-anxiety drug

Moderate value
Evidence A
Buys life
Costs a little
Takes time daily
Long-term effort

In plain words

For people diagnosed with an anxiety disorder, an 8-week mindfulness-based stress reduction course improved symptoms about as much as taking the anti-anxiety drug escitalopram. Nearly 80% of the people on the drug had side effects, and some dropped out because of them. About 15% of those taking the course did, and no one dropped out. It has to be the standardized 8-week course, and any random meditation app does not count.

Cost: The course costs some money. It runs 8 weeks, one class a week, plus daily practice at home. The hard part is practicing every day for 8 weeks in a row.
What you get: This is a trial run at 3 urban academic medical centers in the U.S., designed to see whether the course is no worse than the drug (a noninferiority randomized controlled trial). 276 adults diagnosed with an anxiety disorder were randomly split 1:1. One group took an 8-week mindfulness-based stress reduction course. The other took escitalopram (flexible dose of 10 to 20 mg). 208 people completed the whole course. At the end, scored on the doctor-rated severity of anxiety (the Clinical Global Impression Severity scale), the mindfulness group fell by 1.35 and the drug group by 1.43. The difference between groups was −0.07 (95% CI −0.38 to 0.23, meaning the true gap probably falls within this range; P=0.65, meaning this gap can't be told apart from no difference). The lower limit of this range did not cross the "not worse" line set in advance (the noninferiority margin −0.495). The side effects differed greatly: in the drug group 78.6% had at least one adverse event linked to the trial, and 10 people dropped out because of it. In the mindfulness group, 15.4% did, and no one dropped out because of it.
Notes: The trial used the standardized 8-week mindfulness-based stress reduction (MBSR) course, and any random meditation app cannot be treated as equal to it. It applies to people who already meet the diagnostic criteria for an anxiety disorder, and they should still see a doctor. If you have been putting off treatment because of worry about drug side effects, this is an option with comparable strength of evidence.
Evidence grade: A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources: Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM (2023). Mindfulness-based stress reduction vs escitalopram for the treatment of adults with anxiety disorders: a randomized clinical trial. JAMA Psychiatry, 80(1), 13-21. https://doi.org/10.1001/jamapsychiatry.2022.3679

Translated from the Chinese original. Original book, section 22, tip 7. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer