NEW YORK (Reuters Health) – Patients with major depressive disorder respond faster to treatment with citalopram when given pindolol concomitantly, and the strategy also increases the rate of sustained remission.

Those findings come from a double-blind randomized trial conducted by a Spanish team and reported in the Journal of Clinical Psychiatry issued online October 19.

Dr. Maria J. Portella, with the Hospital de la Santa Creu i Sant Pau and the Universitat Autonoma de Barcelona, and colleagues explain that the beta-antagonist pindolol also inhibits 5-HT autoreceptors and potentiates the increase in extracellular serotonin produced by SSRI antidepressants.

There have been several trials testing the potentiating effect of pindolol, the team notes, but “the findings have been somewhat controverted.” One reason may be that the commonly used pindolol dose of 2.5 mg t.i.d. was suboptimal.

The authors conducted a study in which that dose was doubled. They randomized 30 patients with major depressive disorder to citalopram plus pindolol 5 mg t.i.d. or to citalopram plus placebo for 6 weeks. Outcomes were measured using the Hamilton Depression Rating Scale.

The median time to first response was 22 days for the pindolol group and 30 days for the placebo group (p=0.03), according to the report. Furthermore, over the 42-day study period, “pindolol treatment clearly increased the likelihood of sustaining remission (OR = 5.00; p=0.03).”

Dr. Portella and colleagues conclude, “The results of this study represent further evidence of the acceleration and enhancement of efficacy with pindolol administered together with SSRIs. Pindolol augmentation implied a speedup of citalopram effect, observed in a more rapid and pronounced decrease of clinical scores in a sample with nonrefractory major depressive disorder.”

Nevertheless, they add, further studies are needed to evaluate the long-term effects of pindolol co-administration.

Reference:

Can We Really Accelerate and Enhance the Selective Serotonin Reuptake Inhibitor Antidepressant Effect? A Randomized Clinical Trial and a Meta-Analysis of Pindolol in Nonresistant Depression

J Clin Psychiatry 2010.