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Pindolol augmentation in depressed patients resistant to selective serotonin reuptake inhibitors: a double-blind, randomized, controlled trial.

Abstract

BACKGROUND

Studies of pindolol augmentation of antidepressants in major depressive disorder have produced mixed results, and data in treatment-resistant patients are limited. Here, we report on a double-blind, randomized, controlled 6-week study of pindolol augmentation of selective serotonin reuptake inhibitors (SSRIs) in depressed outpatients resistant to SSRI monotherapy.

METHOD

Forty-two outpatients with DSM-IV major depressive disorder who had an insufficient response to an adequate trial of an SSRI (fluoxetine, paroxetine, or sertraline) were randomly assigned to pindolol, 2.5 mg t.i.d., or sham augmentation, in addition to continued SSRI administration. For separate analysis, the control group underwent a single-blinded switch to pindolol, 2.5 mg t.i.d., from week 4 through week 6, while the active group was continued on pindolol augmentation (hemi-crossover design). Change in Hamilton Rating Scale for Depression (HAM-D) score from baseline to the end of week 3 was the primary outcome measure. Data were gathered from February 1994 to August 1998.

RESULTS

Thirty-eight patients completed at least 1 week on protocol, with 21 and 17 randomly assigned to the pindolol and control groups, respectively. After 3 weeks on protocol, partial response rates (i.e., minimum 50% decrease from baseline in HAM-D score and maximum absolute score of 15) for the pindolol (19% [4/21]) and control (24% [4/17]) groups were comparable. At 3 weeks, the pindolol and control groups demonstrated mean +/- SD decreases in HAM-D scores of 6.5 +/- 9.8 and 9.7 +/- 7.2, respectively. There were no significant differences in antidepressant response or side effects between the 2 groups.

CONCLUSION

These results do not support the efficacy of pindolol in augmenting clinical response to SSRIs in treatment-resistant depressed patients.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Psychiatry, VA Connecticut Healthcare System, Psychiatry Service-116A, 950 Campbell Avenue, West Haven, CT 06516, USA. edward.perry@yale.edu

    , , , ,

    Source

    The Journal of clinical psychiatry 65:2 2004 Feb pg 238-43

    MeSH

    Adrenergic beta-Antagonists
    Adult
    Aged
    Connecticut
    Cross-Over Studies
    Depressive Disorder, Major
    Double-Blind Method
    Drug Resistance
    Drug Therapy, Combination
    Female
    Fluoxetine
    Hospitals, Veterans
    Humans
    Male
    Middle Aged
    Paroxetine
    Personality Inventory
    Pindolol
    Serotonin Uptake Inhibitors
    Sertraline
    Treatment Outcome
    Veterans

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    15003079

    Citation

    Perry, Edward B., et al. "Pindolol Augmentation in Depressed Patients Resistant to Selective Serotonin Reuptake Inhibitors: a Double-blind, Randomized, Controlled Trial." The Journal of Clinical Psychiatry, vol. 65, no. 2, 2004, pp. 238-43.
    Perry EB, Berman RM, Sanacora G, et al. Pindolol augmentation in depressed patients resistant to selective serotonin reuptake inhibitors: a double-blind, randomized, controlled trial. J Clin Psychiatry. 2004;65(2):238-43.
    Perry, E. B., Berman, R. M., Sanacora, G., Anand, A., Lynch-Colonese, K., & Charney, D. S. (2004). Pindolol augmentation in depressed patients resistant to selective serotonin reuptake inhibitors: a double-blind, randomized, controlled trial. The Journal of Clinical Psychiatry, 65(2), pp. 238-43.
    Perry EB, et al. Pindolol Augmentation in Depressed Patients Resistant to Selective Serotonin Reuptake Inhibitors: a Double-blind, Randomized, Controlled Trial. J Clin Psychiatry. 2004;65(2):238-43. PubMed PMID: 15003079.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pindolol augmentation in depressed patients resistant to selective serotonin reuptake inhibitors: a double-blind, randomized, controlled trial. AU - Perry,Edward B, AU - Berman,Robert M, AU - Sanacora,Gerard, AU - Anand,Amit, AU - Lynch-Colonese,Kathleen, AU - Charney,Dennis S, PY - 2004/3/9/pubmed PY - 2004/4/20/medline PY - 2004/3/9/entrez SP - 238 EP - 43 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 65 IS - 2 N2 - BACKGROUND: Studies of pindolol augmentation of antidepressants in major depressive disorder have produced mixed results, and data in treatment-resistant patients are limited. Here, we report on a double-blind, randomized, controlled 6-week study of pindolol augmentation of selective serotonin reuptake inhibitors (SSRIs) in depressed outpatients resistant to SSRI monotherapy. METHOD: Forty-two outpatients with DSM-IV major depressive disorder who had an insufficient response to an adequate trial of an SSRI (fluoxetine, paroxetine, or sertraline) were randomly assigned to pindolol, 2.5 mg t.i.d., or sham augmentation, in addition to continued SSRI administration. For separate analysis, the control group underwent a single-blinded switch to pindolol, 2.5 mg t.i.d., from week 4 through week 6, while the active group was continued on pindolol augmentation (hemi-crossover design). Change in Hamilton Rating Scale for Depression (HAM-D) score from baseline to the end of week 3 was the primary outcome measure. Data were gathered from February 1994 to August 1998. RESULTS: Thirty-eight patients completed at least 1 week on protocol, with 21 and 17 randomly assigned to the pindolol and control groups, respectively. After 3 weeks on protocol, partial response rates (i.e., minimum 50% decrease from baseline in HAM-D score and maximum absolute score of 15) for the pindolol (19% [4/21]) and control (24% [4/17]) groups were comparable. At 3 weeks, the pindolol and control groups demonstrated mean +/- SD decreases in HAM-D scores of 6.5 +/- 9.8 and 9.7 +/- 7.2, respectively. There were no significant differences in antidepressant response or side effects between the 2 groups. CONCLUSION: These results do not support the efficacy of pindolol in augmenting clinical response to SSRIs in treatment-resistant depressed patients. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/15003079/Pindolol_augmentation_in_depressed_patients_resistant_to_selective_serotonin_reuptake_inhibitors:_a_double_blind_randomized_controlled_trial_ L2 - http://www.psychiatrist.com/jcp/article/pages/2004/v65n02/v65n0215.aspx DB - PRIME DP - Unbound Medicine ER -