Abstract
A double-blind study was undertaken to investigate the period of treatment with the β-adrenoreceptor/5-hydroxytryptamine 1A (5-HT(1A)) antagonist pindolol required to enhance the antidepressant effects of paroxetine. After 1 week of a placebo run-in period, 63 untreated major depressive inpatients were randomly assigned to three different groups. Group 1 received paroxetine (20 mg/day) plus placebo (4 weeks). Group 2 received paroxetine (20 mg/day) plus pindolol (7.5 mg/day) for 1 week and placebo for 3 weeks. Group 3 received both active treatments for the entire duration of the study (4 weeks). Clinical response was defined as a reduction of the score in the Hamilton Rating Scale for Depression (HAM-D) to 8 or below. Also, to preliminarily examine whether β-adrenoreceptor blockade was involved in the action of pindolol, another group of 10 inpatients was treated in an open-label manner with paroxetine (20 mg/day) plus 50 mg/day of the β-adrenergic antagonist metoprolol, devoid of significant affinity for 5-HT(1A) receptors. At endpoint, the incidence of treatment-emergent side effects did not significantly differ among the three groups. After 1 and 2 weeks of treatment, the two groups treated with paroxetine plus pindolol displayed a significantly greater response rate than the group treated with paroxetine plus placebo. At study completion, only the patients treated with pindolol for the entire period showed a significantly greater response rate (p = 0.05). HAM-D scores were also significantly lower at endpoint in patients treated with the combination for 4 weeks (p = 0.00003). The group of patients treated with paroxetine and metoprolol exhibited a side-effect profile comparable to that of paroxetine alone. Response rates were also comparable. These findings support the efficacy of pindolol, but not of metoprolol, in accelerating the antidepressant effect of paroxetine and suggest that the administration of pindolol for the entire period of the acute treatment may increase the efficacy of paroxetine.
| Original language | English |
|---|---|
| Pages (from-to) | 446-450 |
| Number of pages | 5 |
| Journal | Journal of Clinical Psychopharmacology |
| Volume | 17 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 1997 |
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ASJC Scopus subject areas
- Pharmacology (medical)
- Psychiatry and Mental health
- Pharmacology, Toxicology and Pharmaceutics(all)
Cite this
How long should pindolol be associated with paroxetine to improve the antidepressant response? / Zanardi, Raffaella; Artigas, Francesc; Franchini, Linda; Sforzini, Laura; Gasperini, Mariangela; Smeraldi, Enrico; Perez, Jorge.
In: Journal of Clinical Psychopharmacology, Vol. 17, No. 6, 12.1997, p. 446-450.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - How long should pindolol be associated with paroxetine to improve the antidepressant response?
AU - Zanardi, Raffaella
AU - Artigas, Francesc
AU - Franchini, Linda
AU - Sforzini, Laura
AU - Gasperini, Mariangela
AU - Smeraldi, Enrico
AU - Perez, Jorge
PY - 1997/12
Y1 - 1997/12
N2 - A double-blind study was undertaken to investigate the period of treatment with the β-adrenoreceptor/5-hydroxytryptamine 1A (5-HT(1A)) antagonist pindolol required to enhance the antidepressant effects of paroxetine. After 1 week of a placebo run-in period, 63 untreated major depressive inpatients were randomly assigned to three different groups. Group 1 received paroxetine (20 mg/day) plus placebo (4 weeks). Group 2 received paroxetine (20 mg/day) plus pindolol (7.5 mg/day) for 1 week and placebo for 3 weeks. Group 3 received both active treatments for the entire duration of the study (4 weeks). Clinical response was defined as a reduction of the score in the Hamilton Rating Scale for Depression (HAM-D) to 8 or below. Also, to preliminarily examine whether β-adrenoreceptor blockade was involved in the action of pindolol, another group of 10 inpatients was treated in an open-label manner with paroxetine (20 mg/day) plus 50 mg/day of the β-adrenergic antagonist metoprolol, devoid of significant affinity for 5-HT(1A) receptors. At endpoint, the incidence of treatment-emergent side effects did not significantly differ among the three groups. After 1 and 2 weeks of treatment, the two groups treated with paroxetine plus pindolol displayed a significantly greater response rate than the group treated with paroxetine plus placebo. At study completion, only the patients treated with pindolol for the entire period showed a significantly greater response rate (p = 0.05). HAM-D scores were also significantly lower at endpoint in patients treated with the combination for 4 weeks (p = 0.00003). The group of patients treated with paroxetine and metoprolol exhibited a side-effect profile comparable to that of paroxetine alone. Response rates were also comparable. These findings support the efficacy of pindolol, but not of metoprolol, in accelerating the antidepressant effect of paroxetine and suggest that the administration of pindolol for the entire period of the acute treatment may increase the efficacy of paroxetine.
AB - A double-blind study was undertaken to investigate the period of treatment with the β-adrenoreceptor/5-hydroxytryptamine 1A (5-HT(1A)) antagonist pindolol required to enhance the antidepressant effects of paroxetine. After 1 week of a placebo run-in period, 63 untreated major depressive inpatients were randomly assigned to three different groups. Group 1 received paroxetine (20 mg/day) plus placebo (4 weeks). Group 2 received paroxetine (20 mg/day) plus pindolol (7.5 mg/day) for 1 week and placebo for 3 weeks. Group 3 received both active treatments for the entire duration of the study (4 weeks). Clinical response was defined as a reduction of the score in the Hamilton Rating Scale for Depression (HAM-D) to 8 or below. Also, to preliminarily examine whether β-adrenoreceptor blockade was involved in the action of pindolol, another group of 10 inpatients was treated in an open-label manner with paroxetine (20 mg/day) plus 50 mg/day of the β-adrenergic antagonist metoprolol, devoid of significant affinity for 5-HT(1A) receptors. At endpoint, the incidence of treatment-emergent side effects did not significantly differ among the three groups. After 1 and 2 weeks of treatment, the two groups treated with paroxetine plus pindolol displayed a significantly greater response rate than the group treated with paroxetine plus placebo. At study completion, only the patients treated with pindolol for the entire period showed a significantly greater response rate (p = 0.05). HAM-D scores were also significantly lower at endpoint in patients treated with the combination for 4 weeks (p = 0.00003). The group of patients treated with paroxetine and metoprolol exhibited a side-effect profile comparable to that of paroxetine alone. Response rates were also comparable. These findings support the efficacy of pindolol, but not of metoprolol, in accelerating the antidepressant effect of paroxetine and suggest that the administration of pindolol for the entire period of the acute treatment may increase the efficacy of paroxetine.
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UR - http://www.scopus.com/inward/citedby.url?scp=0031396455&partnerID=8YFLogxK
U2 - 10.1097/00004714-199712000-00002
DO - 10.1097/00004714-199712000-00002
M3 - Article
C2 - 9408806
AN - SCOPUS:0031396455
VL - 17
SP - 446
EP - 450
JO - Journal of Clinical Psychopharmacology
JF - Journal of Clinical Psychopharmacology
SN - 0271-0749
IS - 6
ER -