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Am J Psychiatry 1997; 154:37-43
Copyright © 1997 by American Psychiatric Association
Effect of pindolol in hastening response to fluoxetine in the treatment of major depression: a double-blind, placebo-controlled trial
RM Berman, AM Darnell, HL Miller, A Anand and DS Charney
Department of Psychiatry, West Haven VA Medical Center, CT 06516, USA.
OBJECTIVE: In two preliminary studies, pindolol produced robust results in
hastening clinical response to antidepressant drugs in depressed patients.
Validity of those pilot studies was limited by use of an open- label,
unblinded study design, and so the authors conducted a double- blind,
placebo-controlled trial to assess the effectiveness of pindolol in
hastening response to fluoxetine. METHOD: Drug-free outpatients with major
depression were concurrently treated with fluoxetine (20 mg/day) and either
placebo or pindolol (5.0 mg b.i.d. or 2.5 mg t.i.d.), for 6 weeks, in a
randomized, double-blind manner. After 6 weeks, all patients received
fluoxetine and placebo and were followed for 3 further weeks in a
single-blind manner. RESULTS: Forty-three patients completed at least 1
week of the protocol. Rates of partial remission after 2 weeks of treatment
with fluoxetine and either pindolol or placebo were 17% (four of 23
patients) and 20% (four of 20 patients), respectively. At study completion,
65% of the patients (N = 28) demonstrated at least a partial remission, and
there was no difference between treatment groups. The pindolol group, but
not the placebo group, demonstrated significant reductions in blood
pressure and pulse rate. The average time to remission and the rates of
attrition, overall response, and side effects were similar in the two
groups. CONCLUSIONS: These findings do not support the efficacy of pindolol
in hastening clinical response in patients treated with fluoxetine.
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