Transcendental meditation has potential benefits for combat-related posttraumatic stress disorder (PTSD), a small case series of U.S. military veterans showed.
Five veterans of the Iraq and Afghanistan wars all had significant improvement on the Clinician-Administered PTSD Scale (CAPS) -- the gold standard for the assessment and diagnosis of PTSD -- after eight weeks of meditation (P=0.02), according to Joshua Rosenthal, MD, of Capital Clinical Research Associates in Rockville, Md., and colleagues.
There were also improvements on some secondary endpoints, the researchers reported in the June issue of Military Medicine.
Although the benefits could not be tied definitively to the meditation because the study lacked a control group, the results were similar to a small randomized controlled trial that compared transcendental meditation with psychotherapy among Vietnam War veterans.
"Together, the results of this and the earlier study support the potential role of transcendental meditation in improving symptoms of PTSD and quality of life in combat veterans, and support the value of conducting larger, controlled studies to further explore the efficacy of this technique in this population," the authors wrote.
PTSD affects 14% of deployed military personnel and about 44% of deployed personnel who suffer a mild traumatic brain injury and see a high level of combat.
Although much attention has been given to the problem, only one treatment has been determined to have enough data to support its efficacy -- prolonged exposure therapy, in which affected individuals experience real or surrogate threats in a safe environment to help overcome their fears -- according to a 2007 report from the National Academy of Sciences.
The report pointed out that the numerous other pharmacologic treatments and psychotherapies may or may not be effective, but lack definitive evidence of their usefulness.
"Since PTSD is associated with persistent symptoms of increased arousal and an exaggerated sympathetic response to stimuli, we have explored an intervention that might counteract this response through improved relaxation," Rosenthal and his colleagues wrote in their paper.
Long-term practice of transcendental meditation has been shown to lower blood pressure, metabolism, and stress reactivity in previous studies.
In the current study, five male veterans ages 25 to 40 from the wars in Iraq and Afghanistan agreed to undergo meditation training and perform 20-minute sessions twice a day for eight weeks. The participants could continue existing PTSD treatments as long as they did not change during the study.
Participants' deployment time ranged from 10 months to two years, and all had experienced at least moderate levels of combat.
Instructors trained the participants in the technique of transcendental meditation at baseline and monitored them weekly for compliance. Compliance with the twice-daily meditation was more than 90% during the study.
The primary endpoint was change in CAPS score, which improved in all participants by an average of 31.4 points at eight weeks.
All five participants also improved on two secondary endpoints -- the Quality of Life Enjoyment and Satisfaction Questionnaire (mean change of -13 points, P<0.01) and the PTSD Checklist-Military Version (mean change of 24 points, P<0.02).
Four of the men were much or very much improved on the Clinical Global Impression-Improvement scale (mean change of 1.6 points, P<0.04). The fifth -- who remained unchanged overall -- showed significant improvement at four weeks but relapsed after stopping temazepam at the instruction of his psychiatrist.
Although three of the participants improved considerably on the Beck Depression Inventory, the mean change for the patient population was not significant (P=0.14).
At week 12, there was a final clinic visit, at which all five men reported continuing transcendental meditation and feeling calmer, less stressed, and less anxious.
Some also reported sleeping better, having more clarity and peace in their lives, and feeling happier, more focused, and more deeply rested.
"Subjects also described getting along with and communicating better with family, friends, and co-workers, and being more engaged in their daily lives," the authors wrote.
Rosenthal and his colleagues said that the potential benefits of transcendental meditation for treating PTSD are that it is easy to learn and can be performed almost anywhere, avoiding the possible stigma of visiting a mental health provider.
Primary source: Military Medicine
Source reference: Rosenthal J, et al "Effects of transcendental meditation (TM) in veterans of Operating Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with posttraumatic stress disorder (PTSD): a pilot study" Military Medicine 2011; 176: 626-630.