Treatment for anxiety: Mindfulness meditation versus escitalopram (TAME): Design of a randomized, controlled non-inferiority trial

Hoge, Elizabeth A.; Bui, Éric; Philip, Samantha R.; Gabriel, Caroline; Ward, Meredith J.; Suzuki, Rebecca; Dutton, Mary Ann; Simon, Naomi M.

doi:10.1016/j.cct.2020.105965

Cited by 6 publications

(7 citation statements)

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“…Our study protocol and analysis plan are published in full elsewhere and in Supplement 1 . Treatments for Anxiety: Meditation and Escitalopram (TAME) is a prospective randomized 2-arm parallel-group controlled single-blinded (blinded raters, with unblinded providers and participants) trial to evaluate the relative effectiveness of 8 weeks of MBSR vs escitalopram.…”

Section: Methodsmentioning

confidence: 99%

“…A diagnosis was determined primary (using clinical judgment with participant input) as the condition with the most severe symptoms and that caused the greatest amount of interference and distress for the patient in their daily life. Eligibility criteria have been described elsewhere and were selected to include a generalizable population of adults with anxiety disorders. Briefly, major exclusion criteria included lifetime bipolar disorder, psychotic disorders, or obsessive compulsive disorder as well as current anorexia or bulimia nervosa, posttraumatic stress disorder, substance use disorders, or significant active suicidal ideation or behaviors.…”

Section: Methodsmentioning

confidence: 99%

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Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders

et al. 2023

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ImportanceAnxiety disorders are common, highly distressing, and impairing conditions. Effective treatments exist, but many patients do not access or respond to them. Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) are popular and can decrease anxiety, but it is unknown how they compare to standard first-line treatments.ObjectiveTo determine whether MBSR is noninferior to escitalopram, a commonly used first-line psychopharmacological treatment for anxiety disorders.Design, Setting, and ParticipantsThis randomized clinical trial (Treatments for Anxiety: Meditation and Escitalopram [TAME]) included a noninferiority design with a prespecified noninferiority margin. Patients were recruited between June 2018 and February 2020. The outcome assessments were performed by blinded clinical interviewer at baseline, week 8 end point, and follow-up visits at 12 and 24 weeks. Of 430 individuals assessed for inclusion, 276 adults with a diagnosed anxiety disorder from 3 urban academic medical centers in the US were recruited for the trial, and 208 completed the trial.InterventionsParticipants were 1:1 randomized to 8 weeks of the weekly MBSR course or the antidepressant escitalopram, flexibly dosed from 10 to 20 mg.Main Outcomes and MeasuresThe primary outcome measure was anxiety levels as assessed with the Clinical Global Impression of Severity scale (CGI-S), with a predetermined noninferiority margin of −0.495 points.ResultsThe primary noninferiority sample consisted of 208 patients (102 in MBSR and 106 in escitalopram), with a mean (SD) age of 33 (13) years; 156 participants (75%) were female; 32 participants (15%) were African American, 41 (20%) were Asian, 18 (9%) were Hispanic/Latino, 122 (59%) were White, and 13 (6%) were of another race or ethnicity (including Native American or Alaska Native, more than one race, or other, consolidated owing to low numbers). Baseline mean (SD) CGI-S score was 4.44 (0.79) for the MBSR group and 4.51 (0.78) for the escitalopram group in the per-protocol sample and 4.49 (0.77) vs 4.54 (0.83), respectively, in the randomized sample. At end point, the mean (SD) CGI-S score was reduced by 1.35 (1.06) for MBSR and 1.43 (1.17) for escitalopram. The difference between groups was −0.07 (0.16; 95% CI, −0.38 to 0.23; P = .65), where the lower bound of the interval fell within the predefined noninferiority margin of −0.495, indicating noninferiority of MBSR compared with escitalopram. Secondary intent-to-treat analyses using imputed data also showed the noninferiority of MBSR compared with escitalopram based on the improvement in CGI-S score. Of patients who started treatment, 10 (8%) dropped out of the escitalopram group and none from the MBSR group due to adverse events. At least 1 study-related adverse event occurred for 110 participants randomized to escitalopram (78.6%) and 21 participants randomized to MBSR (15.4%).Conclusions and RelevanceThe results from this randomized clinical trial comparing a standardized evidence-based mindfulness-based intervention with pharmacotherapy for the treatment of anxiety disorders found that MBSR was noninferior to escitalopram.Trial RegistrationClinicalTrials.gov Identifier: NCT03522844

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders

et al. 2023

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“…Mindfulness-based cognitive therapy was more effective than emotion-regulation training in reducing social anxiety and the fear component among teenagers prone to addiction, and this effect lasted during the follow-up phase. While there have been no studies to compare these two therapeutic methods in terms of social anxiety reduction, studies focusing on either one of these two methods indicate the effectiveness of both, especially mindfulness-based cognitive therapy, on reducing social anxiety [50][51][52][53][54][55][56][57][58]. The explanation for this finding is that, based on the theory of Linehan, social anxiety is always caused by the judgments and attitudes of individuals, lack of awareness about the consequences of actions and reactions among people, past events, and not predicting the future, while mindfulness-based cognitive therapy emphasizes avoiding judgment, purposeful awareness, and focusing on the present moment.…”

Section: Discussionmentioning

confidence: 99%

“…Mindfulness-based cognitive therapy can help reduce the mental obsession of individuals with negative evaluations of themselves, which often results in increased fear. Hoge et al [50] indicate that mindfulness-based therapies are an effective intervention method for various types of anxiety disorders, including social anxiety. Moreover, Rasmussen and Pidgeon [53] indicate that mindfulness significantly predicts high levels of self-esteem and low levels of social anxiety.…”

Section: Discussionmentioning

confidence: 99%

Experimental study of noise emission pattern based on acoustic characteristics in typical industrial manufactorys in Hamadan

Kashefinishabouri

Saadi

Pasha

et al. 2023

johe

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Article InfoBackground: The issue of addiction among teenagers is critically important due to the sensitive nature of this life stage and its role in their future life. The present study aims to investigate the effectiveness of mindfulness-based cognitive therapy and emotionregulation training on rumination and social anxiety in teenagers prone to addiction living in group foster care centers in 2018. Materials and Methods: This is an experimental research with a pre-test, post-test, and follow-up design. The statistical population included all male teenagers aged 13 to 18 years living in group foster care centers of Tehran in 2018. Using the convenience sampling method, 45 teenagers were selected and randomly divided into two experimental groups and a control group (n= 15 per group). The research instrument included the Addiction Potential Scale (APS), the Social Phobia Inventory (SPIN), and the Ruminative Response Scale (RRS). SPSS version 22.0 was further used to analyze the data. Results: The mean of the post-test scores of rumination and physiological symptoms in the cognitive therapy group (55.00±2.00 and 10.47±1.88, respectively) and the emotionregulation group (61.80±5.28 and 11.40±1.24, respectively) were significantly lower than them in the control groups (69.07 ± 1.99 and 13.00 ± 1.55, respectively). The results indicated a significant effect of mindfulness-based cognitive therapy and emotionregulation training on rumination and social anxiety in teenagers (p<0.05). Conclusion:Mindfulness-based cognitive therapy and emotion-regulation training can be used to reduce the social anxiety and rumination of teenagers prone to addiction.

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“…Os resultados indicam a redução de pelo menos 30% dos sintomas de dor crônica e aguda e, consequentemente, dos medicamentos opioides. Treatment for Anxiety: Mindfulness meditation versus Escitalopram (TAME): design of a randomized, controlled non-inferiority trial 17 Protocolo de estudo que sugere a comparação duplo cego entre o uso de Escitalopram e a prática da técnica meditativa por 8 semanas nos distúrbios de ansiedade, ansiedade social, pânico e agorafobia.…”

Section: Mindfulness-based Stress Reduction (Mbsr)unclassified

Autoconhecimento e saúde: a meditação e o uso irracional de medicamentos

Menezes

Gomides²,

Lima³

2022

Rev Neurocienc

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Introdução. A prática da meditação tem apresentado inúmeras vantagens no cenário terapêutico e preventivo. Estudos apontam a técnica como ferramenta para minimizar a dependência farmacológica, importante em casos de uso irracional. Objetivo. O presente estudo destaca exercícios meditativos e seus principais benefícios associados. Método. Para tal, foi realizada uma revisão da literatura nas bases de dados: Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Pubmed) e Directory of Open Acess Journals (DOAJ), em inglês, com os descritores “meditation” e “pharmacotherapy”. Resultado. Foram incluídos 14 estudos, publicados entre 2018 e 2020, permitindo a análise por três categorias: o processo de autoconhecimento humano; o uso de diferentes técnicas na clínica; a associação à terapia medicamentosa no processo de cura. Conclusão. A partir da análise, foram apresentados particularidades e benefícios das técnicas meditativas Heartfulness e Mindfulness-Based, como: opção terapêutica isolada ou adjuvante, redução da frequência e dosagem de medicamentos e ampliação do autoconhecimento. Os achados sugerem o potencial de reescrever o caminho de cuidado em saúde através da meditação, reduzindo efeitos adversos das terapias convencionais e intensificando a exclusão de maus hábitos inconscientes.

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Treatment for anxiety: Mindfulness meditation versus escitalopram (TAME): Design of a randomized, controlled non-inferiority trial

Cited by 6 publications

References 66 publications

Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders

Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders

Experimental study of noise emission pattern based on acoustic characteristics in typical industrial manufactorys in Hamadan

Autoconhecimento e saúde: a meditação e o uso irracional de medicamentos

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