SEROTONERGIC AUTORECEPTOR BLOCKADE IN THE REDUCTION OF ANTIDEPRESSANTLATENCY - PERSONALITY-VARIABLES AND RESPONSE TO PAROXETINE AND PINDOLOL

No antidepressant currently in use exerts a significant antidepressant effect for at least two to three weeks after the patient starts takin g it. Open studies suggest that, for selective serotonergic re-uptake inhibitor (SSRI) antidepressants, this latency may be reduced when the drug is taken with the 5HT(1A),, receptor blocker pindolol. We have u ndertaken a randomised, placebo controlled, double blind trial of augm entation of the selective SSRI antidepressant paroxetine in combinatio n with pindolol. All our patients (n = 54; mean age 36 [range 19-65]) met criteria for major depression and received a standard dose (20 mg o.d.) of paroxetine plus, randomly, either pindolol (2.5 mg t.d.s.) or placebo for six weeks. We examined personality variables in 48 consec utive subjects according to a short version (TCI-125) of Cloninger et al's self-rated Temperament and Character Inventory (Cloninger et al., 1994) and correlated the results with clinical responses in the trial . The results suggest that personality can influence clinical outcome. After the double blind period patients were offered paroxetine 20 mg or 40 mg for up to 6 months. Twenty-six patients took this up. The res ults suggest that high scores in the temperament dimension of Reward D ependence and low scores in the temperament dimension of Harm Avoidanc e had a better outcome at 6 weeks. Patients who had received paroxetin e and pindolol during the trial and who reported high Novelty Seeking and low Harm Avoidance scores had a better outcome at 6 weeks and 6 mo nths. We suggest that temperament factors may influence outcome of ant idepressant treatment. (C) 1997 Elsevier Science B.V.