A double-blind, randomized, placebo-controlled trial of pindolol augmentation in depressive patients resistant to serotonin reuptake inhibitors. Grup de Recerca en Trastorns Afectius.

Full Abstract

BACKGROUND: Pindolol has been reported to hasten the antidepressant action of selective serotonin reuptake inhibitors in open-label and placebo-controlled trials. Pilot studies also suggested that pindolol could augment the antidepressant response in unresponsive patients. We investigated whether the addition of pindolol can induce a rapid response in treatment-resistant patients. METHODS: After a single-blind lead-in placebo phase of 5 days to exclude placebo responders, 80 outpatients with major depression who did not respond to a minimum of 6 weeks of treatment with clomipramine hydrochloride, 150 mg/d; fluoxetine hydrochloride, 40 mg/d; fluvoxamine maleate, 200 mg/d; or paroxetine hydrochloride, 40 mg/d, were randomly assigned to additionally receive placebo (3 times daily) or pindolol (2.5 mg 3 times daily) for 10 days. The median number of ineffective treatments in the current episode was 2 (range, 1-4). Hamilton Rating Scale for Depression and Montgomery-Asberg Scale for Depression scores were used as primary measures of efficacy. RESULTS: At end point, the Hamilton and Montgomery-Asberg scores and change from baseline in Hamilton score were not significantly different in patients taking placebo or pindolol. The response rate was equal in both groups (12.5%). No differences in the clinical outcome were found when the various pretreatment subgroups were considered. At end point, the plasma concentration of pindolol was 9.9+/-5.1 ng/mL (mean +/- SD; n = 40). CONCLUSIONS: Although pindolol can accelerate the antidepressant action of selective serotonin reuptake inhibitors in previously untreated patients, it does not elicit a rapid clinical response in treatment-resistant patients within a 10-day period.

Author information

Author/s: Pérez, V (V); Soler, J (J); Puigdemont, D (D); Alvarez, E (E); Artigas, F (F);

Affiliation: Department of Psychiatry, Hospital de Sant Pau, Barcelona, Spain.

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Archives of general psychiatry (Arch Gen Psychiatry), published in UNITED STATES. (Language: eng)

Reference: 1999-Apr; vol 56 (issue 4) : pp 375-9

Dates: Created 1999/04/14; Completed 1999/04/14; Revised 2006/11/15;

PMID: 10197835, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Fluoxetine - therapeutic use
Fluvoxamine - therapeutic use
Humans
Male
Middle Aged
Paroxetine - administration & dosage; pharmacology; therapeutic use
Pindolol - administration & dosage; pharmacology; therapeutic use
Placebos
Serotonin Uptake Inhibitors - administration & dosage; pharmacology; therapeutic use
Single-Blind Method

Associated Chemicals: Placebos (0) ; Serotonin Uptake Inhibitors (0) ; Pindolol (13523-86-9) ; Fluvoxamine (54739-18-3) ; Fluoxetine (54910-89-3) ; Paroxetine (61869-08-7)

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