Purpose: School teachers show higher levels of internalized distress compared to those in many other professions. In two exploratory studies, we examine the relative and interactive impacts of mindfulness training (MT) and medication use on reductions in depressive and anxious symptoms in teachers over time. Design/Approach/Methods: These questions are explored using data from two randomized, waitlist-controlled trials of an 8-week teacher MT program. Data on medication use for anxiety or depression were assessed at baseline and revealed that 20% of the study samples reported such use. In addition, symptoms of anxiety and depression were assessed at baseline, post-program, and 3-month follow-up. Findings: Results showed that MT significantly reduced depressive symptoms at post-program and at 3-month follow-up even after accounting for medication use. A similar pattern was found for anxious symptoms in Study 2 (but not Study 1). Comparative effects analysis indicated that MT resulted in stronger declines in depressive and anxious symptoms over time, while the effects of medication remained relatively stable. Originality/Value: Results suggest that MT is an effective tool for reducing internalized distress in public school teachers, adds benefits above and beyond the use of medication for such symptoms in this population, and may result in greater long-term symptom reduction.