Once-daily high-dose pindolol for SSRI-refractory depression

Sokolski, Kenneth N.; Conney, Janet C.; Brown, Brenda; DeMet, Edward M.

doi:10.1016/j.psychres.2003.12.006

Cited by 38 publications

(20 citation statements)

References 15 publications

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“…Its action as an antagonist at 5-HT 1A autoreceptors led to studies on its antidepressant effects [2]. Notwithstanding initial open-label trials suggesting the efficacy of this strategy [9], 3 RCTs were negative [98,99,100], with just a small RCT supporting a benefit of pindolol augmentation for TRD [101]. More studies are needed as there is a lack of consensus in this field [102].…”

Section: Resultsmentioning

confidence: 99%

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

Carvalho

Berk

Hyphantis

et al. 2014

Psychother Psychosom

102

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Background: Major depressive disorder is a prevalent and disabling illness. Notwithstanding numerous advances in the pharmacological treatment of depression, approximately 70% of patients do not remit after first-line antidepressant treatment. Methods: The MEDLINE/PubMed, EMBASE and ClinicalTrials.gov electronic databases were searched from inception to October 1, 2013, for randomized controlled trials (RCT), relevant open-label trials, meta-analyses and ongoing trials of pharmacological and psychotherapeutic approaches to treatment-resistant depression (TRD). Results: Switching to a different antidepressant is a useful option following nonresponse to a first-line agent. Although widely used in clinical practice, there is limited evidence to support antidepressant combination for TRD. Notwithstanding evidence for lithium or T₃ augmentation to be successful in TRD, most studies were carried out when participants were treated with tricyclic antidepressants (TCA). Of the available strategies to augment the response to new-generation antidepressants, the use of some atypical antipsychotics is best supported by evidence. Several novel therapeutic options are currently discussed. Evidence suggests that cognitive therapy (CT) is an effective strategy for TRD. Conclusions: The success of switching to a different antidepressant following a first-line agent is supported by evidence, but there is limited evidence for effective combination strategies. Lithium and T₃ augmentation of TCA have the strongest evidence base for successful treatment of TRD. The use of augmentation of newer-generation antidepressants with atypical antipsychotics is supported by a growing evidence base. Current evidence supports CT as an effective strategy for TRD. There is a need for additional large-scale RCT of TRD. The development of new antidepressants targeting novel pathways opens a promising perspective for the management of TRD.

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Section: Resultsmentioning

confidence: 99%

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

Carvalho

Berk

Hyphantis

et al. 2014

Psychother Psychosom

102

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“…Os estudos sobre DRT apresentaram problemas metodológicos importantes: utilização de diferentes definições de DRT; não-explicitação do critério de definição de resistência utilizado em ensaios (Goodwin et al, 1982;Kramlinger e Post, 1989); utilização de amostras insuficientes (De Montigny et al, 1983;Heninger et al, 1983;Cournoyer et al, 1984;Kantor et al, 1986;Zusky et al, 1988;Schopf et al, 1989;Kramlinger e Post, 1989;Dinan e Barry, 1989;Browne et al, 1990, Stein e Bernardt, 1993Baumann et al, 1996;Nierenberg et al, 2003;Maes et al, 1996;Moreno et al, 1997;Maes et al, 1999;Sokolski et al, 2004;Barbosa et al, 2003); realização de estudos não-controlados com placebo (Hoencamp, 1994;Fava et al, 1994Fava et al, e 2002Maes et al, 1999;Rybakowski et al, 1999;Corya et al, 2006); não-explicitação de inclusão (Maes et al, 1996;Maes et al, 1999;Sokolski et al, 2004), ou inclusão e análise em conjunto, de pacientes com história de episódio(s) de mania ou de hipomania (Heninger et al, 1983;Dinan e Barry, 1989;Schopf et al, 1989;Hoencamp et al, 1994;Katona et al, 1995;Baumann et al, 1996;Stein e Bernardt, 1993;Normann et al, 2002;Barbosa et al, 2003;Dubé et al, 2002a;…”

Section: Discussionunclassified

“…Um dos ensaios avaliou o emprego do pindolol na potencialização da trazodona (Maes et al, 1996); três na potencialização de ISRS (Maes et al, 1999;Sokolski et al, 2004;Perry et al, 2004) e dois na potencialização de ISRS e tricíclicos (Moreno et al, 1997;Perez et al, 1999;Perry et al, 2004). Em três estudos (Maes et al, 1996;Maes et al, 1999;Sokolski et al, 2004) foi encontrada diferença significativa entre associação de pindolol a antidepressivos versus placebo, e em três (Moreno et al, 1997;Perez et al, 1999;Perry et al, 2004) não foi evidenciada tal diferença. Como não existem estudos comparando diretamente a eficácia do pindolol em potencializar diferentes classes de antidepressivos, não é possível afirmar se há diferença na potencialização das diversas classes (Tabela 3).…”

Section: Pindololunclassified

“…As principais falhas encontradas nos estudos duplo-cegos sobre o uso do pindolol na potencialização de antidepressivos foram o uso de amostras pequenas (Maes et al, 1996;Moreno et al, 1997;Maes et al, 1999;Sokolski et al, 2004) e a não-explicitação sobre inclusão ou não de pacientes com história de bipolaridade (Maes et al, 1996;Maes et al, 1999;Sokolski et al, 2004).…”

Section: Pindololunclassified

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Depressão resistente a tratamento: uma revisão das estratégias farmacológicas de potencialização de antidepressivos

Santos¹,

Hara

Stumpf³

et al. 2006

J. bras. psiquiatr.

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ResumoObjetivo: Fazer uma revisão sobre oito estratégias farmacológicas de potencialização de antidepressivos na DRT. Métodos: Fez-se um levantamento bibliográfico de 1990 até janeiro de 2006, nas bases eletrônicas de busca Medline, LILACS e da Biblioteca Cochrane, utilizando-se os termos de busca treatment, resistant, refractory e depression e os descritores depression, drug resistance e augmentation, incluindo apenas ensaios controlados duplo-cegos. Foi consultada a referência dos artigos para obtenção de ensaios realizados em data anterior a 1990 e artigos originais de valor histórico. Resultados: Foram encontrados 17 estudos duplo-cegos com o lítio, seis com o hormônio tireoidiano, dois com a buspirona, seis com o pindolol, um com a carbamazepina, dois com a lamotrigina e quatro com a olanzapina. Foram favoráveis à potencialização 41,2% dos ensaios com lítio; 60% daqueles com hormônio tireoidiano e antidepressivos tricíclicos e nenhum com hormônio tireoidiano e inibidores seletivos da recaptação da serotonina (ISRS); 50% dos com pindolol; 100% dos ensaios com carbamazepina e 40% daqueles com olanzapina. Nenhum dos estudos com a buspirona foi favorável. No único estudo com lamotrigina não houve eficácia de tratamento na avaliação pelo critério principal, mas superioridade ao placebo em critérios secundários. Conclusão: Na DRT há evidência de eficácia apenas em relação ao lítio na potencialização de várias classes de antidepressivos e ao hormônio tireoidiano na potencialização de tricíclicos. A olanzapina foi razoavelmente estudada e sua eficácia não foi estabelecida. Os poucos estudos realizados com a buspirona e o pindolol não comprovaram sua eficácia. A carbamazepina foi muito pouco estudada, e a lamotrigina ainda não foi adequadamente avaliada. Palavras-chave: depressão, resistência a drogas, potencialização. AbstractObjective: The aim of this study is to review eight pharmacologic antidepressant augmentation strategies in TRD. Methods: Database search on Medline, LILACS and Cochrane Library, from 1990 to June 2006 using the words treatment, resistant, refractory, depression and the medical subject headings depression, drug resistance and augmentation. Double-blind controlled trials and reviews were included. We also consulted reference of the articles in order to obtain studies and original articles of historical value from before 1990. Results: There were 17 double-blind trials with lithium, six with thyroid hormone, two with buspirone, six with pindolol one with carbamazepine, two with lamotrigine and four with olanzapine. Forty-one percent of the trials with lithium, 60% of those with thyroid hormone and tricyclics, 0% of the ones with thyroid hormone and selective serotonin reuptake inhibitors (SSRI), 50% of those with pindolol, 100% of those with carbamazepine and 40% of the ones with olanzapine were favorable. No trials with buspirone were favorable. The only trial with lamotrigine did not show efficacy using the main outcome measures. Otherwise, there was superiority over placebo on secondary measu...

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“…All have consistently related changes in serotonin levels to emotional disturbances such as anxiety, depression, obsessive-compulsive disorder and impulse control disorders (e.g., de Win et al, 2004;Kalbitzer et al, 2009;Merens, Willem Van der Does, & Spinhoven, 2007;Nugent et al, 2008;Reimold et al, 2008;Riedel, Klaassen, & Schmitt, 2002;Ruhé, Mason, & Schene, 2007;Savitz, Lucki, & Drevets, 2009;Young & Leyton, 2002). Drugs that increase the amount of synaptic serotonin, such as the selective serotonin re-uptake inhibitor (SSRI), lead to reduced depression and anxiety (Gorman & Kent, 1999;Sokolski, Conney, Brown, & DeMet, 2004;Spillmann et al, 2001). Such treatments also improve performance on decision-making tasks, possibly because decisions are now less driven by over-activation of the aversion circuit (Dannon, Lowengrub, Gonopolski, Musin, & Kotler, 2005;Figgitt & McClellan, 2000;Hollander et al, 2000).…”

Section: Neurotransmitter Pathology and Decision-makingmentioning

confidence: 99%

How genes make up your mind: Individual biological differences and value-based decisions

Ramsøy

Skov

2010

Journal of Economic Psychology

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Once-daily high-dose pindolol for SSRI-refractory depression

Cited by 38 publications

References 15 publications

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

Depressão resistente a tratamento: uma revisão das estratégias farmacológicas de potencialização de antidepressivos

How genes make up your mind: Individual biological differences and value-based decisions

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