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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by SalArmy4me on June 16, 2001, at 8:21:38
I post this from time to time because some people haven't even heard of certain treatment options--so they try other augmentation agents that have less evidence behind them, and work poorly or not at all. Examples of these unproven agents include Omega3s, amantadine, inositol, or all the over-the-counter vitamins, minerals, or herbs--save hypericum.
No augmentation agent will work as well as Lithium. This is the first choice in augmentation according to my doctor and the Harvard Psychiatry Depression Algorithym (http://mhc.com/Algorithms/Depression/). But if you cannot take the side-effects of Lithium, do not have a thyroid deficiency (which exacerbates depression), or have not done well on buspirone, Harvard mentions Visken (rx only: pindolol)--also featured prominently on the New York University Psychiatry website: http://www.med.nyu.edu/Psych/aug/index.html
This treatment for depression is nothing new, actually. Pindolol is a beta-blocker, the only one of its class known to speed up the action of
antidepressants. The main studies done (found on Medline) have used it most effectively with sertraline, although it has been tried and
proven effective with most of the SSRIs, tranylcypromine and moclobemide, and a few of the tricyclics. See Dr. Bob's
Psychopharmacology website (uhs.bsd.uchicago.edu/~bhsiung/tips/tips.html) and look up pindolol for more information.I promote pindolol because it once made the most dramatic difference in my life. I took 10 mg per day in two divided doses. Drawbacks: 1) It MUST be taken in brand form--not generic. 2) It can cause
stomach-upset. This can be remedied with famotidine, cimetidine, or protonix. 3) It takes as long as antidepressants to work, and 4) it cannot be used in the place of a regular antidepressant/anticonvulsant.
But these drawbacks never convinced me to stop using it.Best wishes for your full recovery by Fall...
Posted by Cecilia on June 17, 2001, at 4:18:39
In reply to Pindolol in depression, posted by SalArmy4me on June 16, 2001, at 8:21:38
> I post this from time to time because some people haven't even heard of certain treatment options--so they try other augmentation agents that have less evidence behind them, and work poorly or not at all. Examples of these unproven agents include Omega3s, amantadine, inositol, or all the over-the-counter vitamins, minerals, or herbs--save hypericum.
>
> No augmentation agent will work as well as Lithium. This is the first choice in augmentation according to my doctor and the Harvard Psychiatry Depression Algorithym (http://mhc.com/Algorithms/Depression/). But if you cannot take the side-effects of Lithium, do not have a thyroid deficiency (which exacerbates depression), or have not done well on buspirone, Harvard mentions Visken (rx only: pindolol)--also featured prominently on the New York University Psychiatry website: http://www.med.nyu.edu/Psych/aug/index.html
>
> This treatment for depression is nothing new, actually. Pindolol is a beta-blocker, the only one of its class known to speed up the action of
> antidepressants. The main studies done (found on Medline) have used it most effectively with sertraline, although it has been tried and
> proven effective with most of the SSRIs, tranylcypromine and moclobemide, and a few of the tricyclics. See Dr. Bob's
> Psychopharmacology website (uhs.bsd.uchicago.edu/~bhsiung/tips/tips.html) and look up pindolol for more information.
>
> I promote pindolol because it once made the most dramatic difference in my life. I took 10 mg per day in two divided doses. Drawbacks: 1) It MUST be taken in brand form--not generic. 2) It can cause
> stomach-upset. This can be remedied with famotidine, cimetidine, or protonix. 3) It takes as long as antidepressants to work, and 4) it cannot be used in the place of a regular antidepressant/anticonvulsant.
> But these drawbacks never convinced me to stop using it.
>
> Best wishes for your full recovery by Fall...My pdoc says there`s no evidence that Pindolol actually improves the performance of AD`s, only makes them work faster if they`re going to work. Have you seen studies showing there is a true augmenting effect-if so I`d appreciate the links. I`ve tried both lithium and thyroid as augmenting agents-intolerable side effects with both.
Posted by SalArmy4me on June 17, 2001, at 6:10:40
In reply to Re: Pindolol in depression, posted by Cecilia on June 17, 2001, at 4:18:39
Posted by Cam W. on June 17, 2001, at 9:36:14
In reply to Re: Pindolol in depression » Cecilia, posted by SalArmy4me on June 17, 2001, at 6:10:40
> http://www.med.nyu.edu/Psych/aug/sld020.html
Sal - The link you gave was based on a study in 1995. Further research has shown that pindolol does not really augment antidepressant action and it is now in doubt whether it actually decreases the time to SSRI action. Also, as has been said before, generic and brand name pindolol are bioequivalent. The study in which there was a difference between the brand and generic, was speculated to be a non-bioequivalent lot of the generic pindolol (or outdated drug - I heard a speaker at conference mention this; sorry, I can't remember his name, but I can see his face). Also, the study that had said this was funded by the makers of Visken™.
- Cam
Posted by SalArmy4me on June 17, 2001, at 21:11:56
In reply to Re: Pindolol in depression » SalArmy4me, posted by Cam W. on June 17, 2001, at 9:36:14
I know pindolol works because I've felt it working (no possibility of placebo-effect). I would wager to say that most people will have some relief from depression with the addition of pindolol to an SSRI:
Bordet, Regis MD. Thomas, Pierre MD. Dupuis, Bernard MD, PhD. "Effect of Pindolol on Onset of Action of Paroxetine in the Treatment of Major Depression: Intermediate Analysis of a Double-Blind, Placebo-Controlled Trial." American Journal of Psychiatry. 155(10):1346-1351, October 1998.
I also know for sure that the generic pindolol is not the same as Visken--I've felt that difference.
This is the end of the thread.
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