The use of pindolol to potentiate antidepressant medication.
Serotonin (5-HT) selective reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors are thought to have a delayed onset of antidepressant action attributable in part to the decrease in firing activity of 5-HT neurons they produce upon treatment initiation. As cell body 5-HT1A autoreceptors desensitize, 5-HT neuronal firing is restored. The agent pindolol, through its 5-HT1A receptor blocking property, has been shown to prevent the initial decrease in firing of rat 5-HT neurons associated with SSRI treatment. Four open-label studies put into evidence a significant acceleration of the antidepressant effect of SSRIs when combined with pindolol. Four of five placebo-controlled studies have confirmed this observation. Controlled trials indicate that a greater rate of response may be obtained by combining pindolol from the beginning of the SSRI treatment. The strategy of adding pindolol to the regimen of SSRI-resistant patients also appears to produce a therapeutic effect in a significant proportion of patients.
Blier
P
P
Department of Psychiatry, McGill University, Montréal, Québec, Canada.
Bergeron
R
R
D000818:Animals; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D017660:Autoreceptors / Q000187:drug effects; D018849:Controlled Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006624:Hippocampus / Q000187:drug effects; D006801:Humans; D008297:Male; D008996:Monoamine Oxidase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D010869:Pindolol / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D011985:Receptors, Serotonin / Q000187:drug effects; D012702:Serotonin Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*
D000928:Antidepressive Agents; D017660:Autoreceptors; D008996:Monoamine Oxidase Inhibitors; D010869:Pindolol; D011985:Receptors, Serotonin; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors