Selective serotonin reuptake inhibitors pindolol

Anderson DN, Wilkinson AM, Abou-Saleh MT, et al Recovery from depression after electroconvulsive therapy is accompanied by evidence of increased tetra-hydrobiopterin-dependent hydroxylation. Acta Psychiatr Scand 90 10-13, 1994 Anderson IM, Cowen PJ Effect of pindolol on endocrine and temperature responses to buspirone in healthy volunteers. Psychopharmacology 106 428-432, 1992 Anderson IM, Tomenson BM Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants a meta-analysis. BMJ 310 1433-1438, 1995... 

Bipolar depression affects 1% of the general population, and treatment resistance is a significant problem. The addition of pindolol can lead to significant improvement in depressed patients who are resistant to antidepressant drugs, such as selective serotonin reuptake inhibitors or phenelzine. Of 17 patients with refractory bipolar depression, in whom pindolol was added to augment the effect of antidepressant drugs, eight responded favorably (95). However, two developed transient hypo-mania, and one of these became psychotic after the resolution of hypomanic symptoms. In both cases transient hypomanic symptoms resolved without any other intervention, while psychosis required pindolol withdrawal. 

The clearest demonstration of 5-HT, receptor function which can be linked to therapeutic potential has come from the development of drugs which target the 5-HT, and 5-HT,d receptors. The 5-HT,a partial agonists such as buspirone are clinically useful in the treatment of anxiety [39]. In addition, it has been suggested that antagonists of the 5-HT,a receptor, such as pindolol, may lead to a more rapid onset of antidepressant activity when combined with a selective serotonin reuptake inhibitor [40]. Although this particular... 

Segrave R, Nathan PJ. Pindolol augmentation of selective serotonin reuptake inhibitors accounting for the variability of results of placebo-controlled double-blind studies in patients with major depression. Human Psychopharmacol 2005 20 163-174. 

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