How long should pindolol be associated with paroxetine to improve the antidepressant response?

Raffaella Zanardi, Francesc Artigas, Linda Franchini, Laura Sforzini, Mariangela Gasperini, Enrico Smeraldi, Jorge Perez

Research output: Contribution to journalArticle

161 Citations (Scopus)

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 languageEnglish
Pages (from-to)446-450
Number of pages5
JournalJournal of Clinical Psychopharmacology
Volume17
Issue number6
DOIs
Publication statusPublished - Dec 1997

Fingerprint

Pindolol
Paroxetine
Antidepressive Agents
Metoprolol
Placebos
Inpatients
Therapeutics
Serotonin Antagonists
Receptor, Serotonin, 5-HT1A
Adrenergic Antagonists
Double-Blind Method

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Psychiatry and Mental health
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Zanardi, R., Artigas, F., Franchini, L., Sforzini, L., Gasperini, M., Smeraldi, E., & Perez, J. (1997). How long should pindolol be associated with paroxetine to improve the antidepressant response? Journal of Clinical Psychopharmacology, 17(6), 446-450. https://doi.org/10.1097/00004714-199712000-00002

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 journalArticle

Zanardi, R, Artigas, F, Franchini, L, Sforzini, L, Gasperini, M, Smeraldi, E & Perez, J 1997, 'How long should pindolol be associated with paroxetine to improve the antidepressant response?', Journal of Clinical Psychopharmacology, vol. 17, no. 6, pp. 446-450. https://doi.org/10.1097/00004714-199712000-00002
Zanardi, Raffaella ; Artigas, Francesc ; Franchini, Linda ; Sforzini, Laura ; Gasperini, Mariangela ; Smeraldi, Enrico ; Perez, Jorge. / How long should pindolol be associated with paroxetine to improve the antidepressant response?. In: Journal of Clinical Psychopharmacology. 1997 ; Vol. 17, No. 6. pp. 446-450.
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