Hirschmann S, Dannon P N, Iancu I, Dolberg O T, Zohar J, Grunhaus L
Chaim Sheba Medical Center, Psychiatry Ward, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Israel.
J Clin Psychopharmacol. 2000 Oct;20(5):556-9. doi: 10.1097/00004714-200010000-00011.
The objective of this study was to determine the efficacy of pindolol as an augmentor of fluoxetine in treatment-resistant panic disorder (PD). Twenty-five outpatients having PD with or without agoraphobia were included. These patients had not responded to two different trials with antidepressants and an 8-week trial of fluoxetine 20 mg/day. Treatment-resistant PD was defined as a less than 20% reduction in score on the Panic Self-Questionnaire (number of attacks per week) (PSQ) and the Clinical Anxiety Scale With Panic Attacks (CAS+PA). These patients continued to receive fluoxetine 20 mg/day and were randomly assigned to additionally receive either pindolol (2.5 mg three times daily) or placebo for the following 4 weeks. Evaluations were performed weekly using the Hamilton Rating Scale for Anxiety, the Hamilton Rating Scale for Depression (HAM-D), the CAS+PA, the NIMH Anxiety Scale, the PSQ, and the Clinical Global Impression Scale. The data were analyzed using a repeated-measures analysis of variance (ANOVA) and a t-test for independent samples. Patients treated with the combination of pindolol and fluoxetine (N = 13) demonstrated a significant improvement over the patients treated with fluoxetine and placebo on all rating scales, with the exception of HAM-D. The statistical differences were shown using the repeated-measures ANOVA (baseline, week 2, week 4) and also with t-tests from the second week of the trial. These preliminary results demonstrate that pindolol has an augmenting effect on fluoxetine in patients with treatment-resistant PD.
本研究的目的是确定吲哚洛尔作为氟西汀增效剂在难治性惊恐障碍（PD）治疗中的疗效。纳入了25名患有或未患有广场恐惧症的PD门诊患者。这些患者对两种不同的抗抑郁药试验以及为期8周的每日20毫克氟西汀试验均无反应。难治性PD被定义为惊恐自评问卷（每周发作次数）（PSQ）和伴有惊恐发作的临床焦虑量表（CAS+PA）得分降低不到20%。这些患者继续接受每日20毫克氟西汀治疗，并在接下来的4周内随机分配额外接受吲哚洛尔（每日三次，每次2.5毫克）或安慰剂治疗。每周使用汉密尔顿焦虑评定量表、汉密尔顿抑郁评定量表（HAM-D）、CAS+PA、美国国立精神卫生研究所焦虑量表、PSQ和临床总体印象量表进行评估。数据使用重复测量方差分析（ANOVA）和独立样本t检验进行分析。与接受氟西汀和安慰剂治疗的患者相比，接受吲哚洛尔和氟西汀联合治疗的患者（N = 13）在所有评定量表上均有显著改善，但HAM-D除外。使用重复测量方差分析（基线、第2周、第4周）以及试验第二周起的t检验显示了统计学差异。这些初步结果表明，吲哚洛尔对难治性PD患者的氟西汀具有增效作用。
