Does the addition of pindolol accelerate the response to electroconvulsivetherapy in patients with major depression? A double-blind, placebo-controlled pilot study

There is evidence that addition of pindolol, a beta-adrenergic/5-hydroxytry ptamine-1A antagonist, can accelerate the onset of action of antidepressant medications. The purpose of this study was to determine whether pindolol a dministration can induce a rapid improvement in depressive symptoms in pati ents receiving electroconvulsive therapy (ECT) within six ECT treatments. A total of 20 patients with DSM-IV-diagnosed major depression who were under going a course of ECT as the clinically indicated treatment were recruited. They were neuroleptic, lithium, and antidepressant free for at least 1 wee k before the study. Of the 20 patients, 9 patients had been randomly assign ed to receive pindolol 2.5 mg three times daily, and 11 patients received i dentical placebo three times daily for the duration of the first 6 ECT trea tments. One of 9 patients in the pindolol group and 4 of 11 patients in the placebo group dropped out of the study. Using an outcome measure of a scor e less than or equal to 12 on the 29-item Hamilton Rating Scale for Depress ion (HAM-D), the authors found that four (50%) of eight patients responded to the combination treatment of ECT and pindolol within six ECT treatments. In contrast, none (0%) of seven patients who received placebo responded to ECT treatment. Furthermore, both mean 29-item HAM-D and Clinical Global Im pression Scale scores after the sixth ECT treatment were significantly lowe r in patients treated with pindolol compared with those treated with placeb o. However, the number of total ECT treatments within a course or the overa ll efficacy of ECT treatment was not altered by the addition of pindolol. T he results of this study suggest that within six ECT treatments, pindolol a dministration hastens antidepressant effects of ECT in some depressed patie nts.