Tome M B, Isaac M T, Harte R, Holland C
Department of Psychological Medicine, Guy's Campus, London, UK.
Int Clin Psychopharmacol. 1997 Mar;12(2):81-9.
A double-blind, randomized, placebo-controlled, parallel group study was performed in 80 adult outpatients meeting ICD-10 criteria for major depression and with a Montgomery-Asberg Depression Rating Scale (MADRS) score of at least 18 at baseline. All patients received paroxetine (20 mg once a day) plus either pindolol (2.5 mg three times a day) or matching placebo for 6 weeks. Analysis of the day 14 MADRS scores on an intent-to-treat basis revealed a treatment-by-centre interaction, with a significant effect of pindolol being demonstrable at only one centre. At this centre, 25% of the paroxetine plus pindolol group and 0% of the paroxetine plus placebo group showed a decrease of at least 50% from baseline MADRS by day 4 (p < 0.05). At day 14, the proportions were 73% and 7%, respectively (p < 0.001). Analysis of covariance on a "perprotocol" population demonstrated a significant accelerator effect of pindolol at days 4 and 7 in the absence of a treatment-by-centre interaction, but a centre effect was apparent at later time-points. The results suggest that the latency of antidepressant action can be reduced with pindolol augmentation. A large multicentre study is in progress to investigate this effect further.
对80名符合ICD - 10重度抑郁症标准且蒙哥马利 - 阿斯伯格抑郁评定量表（MADRS）基线评分至少为18分的成年门诊患者进行了一项双盲、随机、安慰剂对照、平行组研究。所有患者接受帕罗西汀（每日一次，20毫克）加心得安（每日三次，2.5毫克）或匹配的安慰剂，为期6周。在意向性治疗基础上对第14天的MADRS评分进行分析，结果显示存在治疗中心交互作用，仅在一个中心可证明心得安有显著效果。在该中心，到第4天，帕罗西汀加心得安组中有25%的患者MADRS评分较基线至少降低了50%，而帕罗西汀加安慰剂组中这一比例为0%（p < 0.05）。到第14天，相应比例分别为73%和7%（p < 0.001）。对“符合方案”人群进行协方差分析表明，在不存在治疗中心交互作用的情况下，心得安在第4天和第7天具有显著的加速作用，但在后期时间点存在中心效应。结果表明，加用心得安可缩短抗抑郁作用的潜伏期。一项大型多中心研究正在进行，以进一步探究这种效应。
