An eight week mindfulness course with a supported taper matched staying on antidepressants for relapse
In 424 adults with three or more past episodes on maintenance antidepressants, MBCT with support to taper and staying on medication did not differ in time to relapse over two years (HR 0.89, 0.67 to 1.18). No evidence MBCT was superior.
Well-supported by good-quality research. how we score evidence
Caveat on this rating: A superiority trial that found no difference is not proof of equivalence; the interval allows a modest advantage either way. Participants knew their allocation. The population was people with three or more episodes on a stable maintenance dose, with their own doctor supporting the taper. This row is a question to bring to a prescriber, not a plan to make from a page.
People who have had depression several times are usually advised to stay on an antidepressant for at least two years to prevent it coming back. Many of them want an alternative. This trial tested one.
Significant findings
Kuyken, Hayes, Barrett and colleagues ran the PREVENT trial in 95 general practices across the United Kingdom. They recruited 424 adults with three or more previous major depressive episodes who were taking a therapeutic dose of a maintenance antidepressant, and randomised 212 to mindfulness based cognitive therapy with support to taper or discontinue the antidepressant (MBCT-TS) and 212 to continuing the antidepressant. Assessors were masked; participants were not. The primary outcome was time to relapse or recurrence over 24 months.
"The time to relapse or recurrence of depression did not differ between MBCT-TS and maintenance antidepressants over 24 months (hazard ratio 0·89, 95% CI 0·67-1·18; p=0·43), nor did the number of serious adverse events." There were five adverse events, including two deaths, in each group, none attributable to the interventions or the trial.
The authors' conclusion is precise and both directions are in it: "We found no evidence that MBCT-TS is superior to maintenance antidepressant treatment for the prevention of depressive relapse", and "both treatments were associated with enduring positive outcomes in terms of relapse or recurrence, residual depressive symptoms, and quality of life."
The other direction
"Did not differ" is not "better". The trial was designed to test whether MBCT was superior, and it was not. The confidence interval (0.67 to 1.18) leaves room for either treatment to be somewhat better. The taper in this trial was supported by the person's own doctor inside a trial protocol.
What this does not show
Nothing in this row is a reason to stop or change an antidepressant. It shows that, for people like the ones in this trial and with medical support, an eight week course followed by a supported taper produced the same relapse rate as staying on the medication. Whether that applies to any one person is a question for their prescriber.
Worth asking
If I want an alternative to staying on medication for years, is a course like this available to me, and what would a supported taper look like?
Source
Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial — Kuyken W, Hayes R, Barrett B, Byng R, Dalgleish T, Kessler D, Lewis G, Watkins E, Brejcha C, Cardy J, Causley A, Cowderoy S, Evans A, Gradinger F, Kaur S, Lanham P, Morant N, Richards J, Shah P, Sutton H, Vicary R, Weaver A, Wilks J, Williams M, Taylor RS, Byford S (2015)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1016/S0140-6736(14)62222-4
DOI: 10.1016/S0140-6736(14)62222-4
How this was scored
- Study design
- Randomised controlled trial
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 424
- Preregistered
- Yes
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 24, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "strong evidence". Well-supported by good-quality research. It scores 82 out of 100 on our published rubric. One caveat travels with that badge: A superiority trial that found no difference is not proof of equivalence; the interval allows a modest advantage either way. Participants knew their allocation. The population was people with three or more episodes on a stable maintenance dose, with their own doctor supporting the taper. This row is a question to bring to a prescriber, not a plan to make from a page. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial — Kuyken W, Hayes R, Barrett B, Byng R, Dalgleish T, Kessler D, Lewis G, Watkins E, Brejcha C, Cardy J, Causley A, Cowderoy S, Evans A, Gradinger F, Kaur S, Lanham P, Morant N, Richards J, Shah P, Sutton H, Vicary R, Weaver A, Wilks J, Williams M, Taylor RS, Byford S (2015). Published in: Top-tier peer-reviewed journal. DOI: 10.1016/S0140-6736(14)62222-4. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Randomised controlled trial. Funding: Independently funded. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.