Fluoxetine/Pindolol Combo More Effective In Depression
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Fluoxetine/Pindolol Combo More Effective In Depression

LONDON -- May 30, 1997 -- Major depression affects up to 5% of the population and often recurs at some point after treatment has ended. Although depression can be treated with drugs, antidepressants are slow to take effect and are effective in up to only two-thirds of patients. In this week's The Lancet, Dr Victor PÇrez and colleagues from Spain and the USA, present the results of an investigation which shows that a combination of the antidepressants fluoxetine and pindolol is more effective than fluoxetine alone in reducing symptoms of depression.

In the trial, 111 patients with depression were randomly assigned fluoxetine (an antidepressive drug) and either a placebo (56), or pindolol (55). The authors hypothesised that the addition of a drug such as pindolol would increase the efficacy of fluoxetine and decrease the time to clinical improvement. To check this, the degree of depression in patients was assessed twice a week for the first three weeks of the trial and once a week thereafter until the end of the trial (42 days).

The number of patients in the fluoxetine and pindolol group who responded to treatment was significantly greater than in the fluoxetine and placebo group (41 of 55 and 33 of 56, respectively), which was a 16% increase. The number of days that it took to reach a sustained response to treatment and the proportion of patients who had a sustained response were also significantly greater in the fluoxetine and pindolol group.

The authors concluded that the addition of pindolol to treatment with fluoxetine seemed to enhance the effectiveness of therapy. However, they added, "further work is needed to resolve whether the time to clinical improvement benefits from this combination and whether the increase in efficacy occurs with other antidepressants."

The authors also felt that study of whether pindolol increases the effectiveness of other antidepressant drugs would be worthwhile as knowledge about the neurobiological mechanisms involved would help in the design of more effective treatments.

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