Bakish D, Hooper C L, Thornton M D, Wiens A, Miller C A, Thibaudeau C A
Department of Psychiatry, University of Ottawa, Canada.
Int Clin Psychopharmacol. 1997 Mar;12(2):91-7.
Pindolol, a beta-adrenergic and presynaptic 5-HT1 vA antagonist, when added to specific serotonin reuptake inhibitors, potentiates the antidepressant action, leading to an earlier onset of effect. Following on from the suggestion that nefazodone, a specific serotonin reuptake inhibitor and antagonist of 5-HT2, improves 5-HT1A-mediated transmission, we used a pindolol and nefazodone combination treatment for major depressive disorder. Twenty outpatients underwent a 4-week trial. Patients were seen twice a week, and completed efficacy and safety measures including the 17-item Hamilton Depression Scale, the Montgomery-Asberg Depression Rating Scale and the Clinical Global Impression scales. Results demonstrated significant improvement in all efficacy measures after one visit (2-4 days of treatment), with decreasing depression scores on all measures continuing throughout the trial. After 1 week of treatment, 15 out of 20 patients had experienced a 50% or greater reduction in their 17-item Hamilton Depression Scale scores. Remission rates were dramatic, with 40% of patients in remission after 1 week of treatment and 90% after 4 weeks. This open study of nefazodone-pindolol combination therapy suggests that this may be a new treatment option for patients with major depressive disorder; however, it needs to be replicated in a double-blind trial before conclusions regarding efficacy and safety can be made.
吲哚洛尔是一种β-肾上腺素能和突触前5-HT1 vA拮抗剂，当添加到特定的5-羟色胺再摄取抑制剂中时，可增强抗抑郁作用，使起效时间提前。基于奈法唑酮（一种特定的5-羟色胺再摄取抑制剂和5-HT2拮抗剂）可改善5-HT1A介导的神经传递这一观点，我们采用吲哚洛尔与奈法唑酮联合治疗重度抑郁症。20名门诊患者接受了为期4周的试验。患者每周接受两次检查，并完成包括17项汉密尔顿抑郁量表、蒙哥马利-阿斯伯格抑郁评定量表和临床总体印象量表在内的疗效和安全性评估。结果显示，在一次就诊（治疗2 - 4天）后，所有疗效指标均有显著改善，且在整个试验过程中所有指标的抑郁评分持续下降。治疗1周后，20名患者中有15名的17项汉密尔顿抑郁量表评分降低了50%或更多。缓解率显著，治疗1周后40%的患者缓解，4周后90%的患者缓解。这项关于奈法唑酮 - 吲哚洛尔联合治疗的开放性研究表明，这可能是重度抑郁症患者的一种新治疗选择；然而，在得出关于疗效和安全性的结论之前，需要在双盲试验中进行重复验证。
