Effectiveness of pindolol plus serotonin uptake inhibitors in depression: a meta-analysis of early and late outcomes from randomised controlled trials

Background: Contradictory results on the efficacy of pindolol associated with selective serotonin reuptake inhibitors (SSRIs) in depressive illness have been published and no former review has produced an overall figure of its efficacy.This study aims to review the efficacy and tolerability of pindolol plus SSRIs in depressive illness. Methods: A meta-analysis of randomised controlled trials (RCTs) comparing pindolol plus SSRIs with placebo plus SSRIs. Results: Nine RCTs met inclusion criteria. Outcome favoured pindolol at 2 weeks time (N=5; OR=2.8; 95% CI 1.4–5.7), but not at four to 6 weeks (N=7; OR=1.4; 95% CI 0.8–2.7). Results for early outcome studies were robust to sensitivity analysis. Nineteen more studies, averaging null results, would be needed to change the overall probability (P=0.0001) to a non-significant figure. Conclusions: Pindolol seems to hasten the response to SSRIs in depression with a timing window circumscribed to the first weeks of treatment.