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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SalArmy4me on January 2, 2001, at 21:52:35
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.htmlThis 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 has made the most dramatic difference in
my life. I take 10 mg per day in two divided doses. Drawbacks: 1) It
is expensive in the brand form. My HMO, the largest in the United
States, does not cover it. That is because other treatments for
hypertension are preferred over pindolol. 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. There's your FYI.
Posted by HenryO on January 3, 2001, at 0:48:03
In reply to Pindolol as augmentation agent, posted by SalArmy4me on January 2, 2001, at 21:52:35
Pindolol is a wonder-drug for me.
Posted by JahL on January 3, 2001, at 3:05:34
In reply to Pindolol as augmentation agent, posted by SalArmy4me on January 2, 2001, at 21:52:35
> 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 has made the most dramatic difference in
> my life. I take 10 mg per day in two divided doses. Drawbacks: 1) It
> is expensive in the brand form. My HMO, the largest in the United
> States, does not cover it. That is because other treatments for
> hypertension are preferred over pindolol. 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. There's your FYI.What do you (& HenryO?) take with it & @ what dose?
Ta,
Jah.
Posted by Anna P. on January 4, 2001, at 23:50:41
In reply to Pindolol as augmentation agent, posted by SalArmy4me on January 2, 2001, at 21:52:35
>Can Pindolol be used together with Lithium and Zyprexa?
Anna P.
Posted by SLS on January 5, 2001, at 6:34:47
In reply to Re: Pindolol drug interactions, posted by Anna P. on January 4, 2001, at 23:50:41
> >Can Pindolol be used together with Lithium and Zyprexa?
>
> Anna P.
I can't think of any reason why not. I will defer to one of our pharmacologists for confirmation.This is an interesting combination. All three drugs work to change serotonin functions from different angles. Please let me know how you do with it should you decide to try it.
Good luck.
- Scott
Posted by danf on January 12, 2001, at 13:41:38
In reply to Re: Pindolol drug interactions, posted by SLS on January 5, 2001, at 6:34:47
I also am a proponent of pindolol 10mg BID
along with now...effexor 75mg bid.
It has done well for me with no side effects... One of my biggest problems was tremor... it is fully controlled with the pindolol..
Posted by SalArmy4me on January 13, 2001, at 22:18:47
In reply to Re: Pindolol as augmentation agent, posted by JahL on January 3, 2001, at 3:05:34
I take 20 mg per day in divided doses with either Protonix or Zantac to relieve the stomachache. I also take Lamictal for my depression. Recently, the pindolol stopped working, so this will be the third medication that has pooped out on me.
Posted by KS on May 1, 2001, at 12:29:55
In reply to Re: Pindolol as augmentation agent, posted by SalArmy4me on January 13, 2001, at 22:18:47
Dear SalArmy4me,
Judging from your many postings, you seem to be a wise veteran at this depression/anxiety thing. Like most of the other contributors to PsychoBabble I'v battled through the usual AD's and have tried augmentations with thyroid, carbamazapine and Topomax without much luck. My 'primary' AD at present is Efexor XR 150mg which I use with about 0.5mg Klonopin tds because the Efexor give me a horrible anxious feeling (NOT clinical anxiety, it's iatrogenic). I'm interested in your knowledge of better augmentation strategies particularly: Lamictal and pindolol. Can you help?
Thanx.
KS
Posted by SalArmy4me on May 2, 2001, at 1:36:35
In reply to Re: Pindolol/Lamictal as augmentation agent, posted by KS on May 1, 2001, at 12:29:55
Lamictal is a viable option for your augmentation because, simply, it works on 5HT1a serotonin receptors--thus alleviating both depression and anxiety (as serotonin usually does). Gabapentin would be another good option....I'll tell you more about pindolol when I finally wake up...
Posted by JohnX on May 5, 2001, at 1:49:04
In reply to Re: Pindolol/Lamictal as augmentation agent » KS, posted by SalArmy4me on May 2, 2001, at 1:36:35
> Lamictal is a viable option for your augmentation because, simply, it works on 5HT1a serotonin receptors--thus alleviating both depression and anxiety (as serotonin usually does). Gabapentin would be another good option....I'll tell you more about pindolol when I finally wake up...
SalArmy4me,
When you wake up, could you direct me to research data regarding Lamictal action at the 5ht1a serotonin receptors. This is new information to me and I am very curious to learn about it.Thanks,
John
Posted by SalArmy4me on May 6, 2001, at 0:58:30
In reply to Re: Pindolol/Lamictal as augmentation agent » SalArmy4me, posted by JohnX on May 5, 2001, at 1:49:04
Just do a medline search using the terms 'lamotrigine' and 'serotonin' together.
This is the end of the thread.
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