Beta-blockers are medications which block the beta-adrenergic system in the body.  They are primarily used for high blood pressure.  The slow down the heart rate.  They are most often used in psychiatry for hand tremors and are excellent for that problem.  Sometimes, they are used for intermittent explosive disorders, i.e., to help reduce anger episodes.  While they have been quite often researched as an adjunct in the treatment of depression, I have never seen any psychiatrist in actual clinical practice use a beta-blocker for that indication.

Pindolol

Value Gone After 10 days: DB PC 100 pt as adjunct to paroxetine by Bordet of Lille in Am J Psychiatry 10/98 155:1346 found combo was doing better at 10 days but after that there was no significant difference.

Pindolol Adjunct Helped Fluoxetine in DB: A higher % recovered (75% vs. 59%) and more quickly (19 day vs. 29 day) in fluoxetine + pindolol 75mg than with fluoxetine and placebo. Perez, Barcelona, Lancet 5/31/97 349:1594

No Help as Adjunct to SSRI: In a DB PC study, no benefit was found. Pindolol Augmentation in Depressed Patients Resistant to Selective Serotonin Reuptake Inhibitors: A Double-Blind, Randomized, Controlled Trial. Perry EB, Berman RM, Sanacora G, Anand A, Lynch-Colonese K, Charney DS. J Clin Psychiatry. 2004 Feb;65(2):238-243

Pindolol Helps Fluvoxamine in Delusional Depression in DB: 72 pts DB PC all on fluvoxamine 300mg/d and some on pindolol 7.5mg/d or placebo. Pindolol group responded faster at 3^rd and 4^th week but both groups equal in the end. Well-tolerated. Zanard, Milan, APA 5/30/98 Toronto

Pindolol Helped Paroxetine/Fluoxetine: Two large PC DB found benefit but no acceleration in response. The Lancet study had 111 adult unipolars rx fluoxetine 20/d with or without pindolol 7.5mg/d for 6 weeks. 75% combo vs. 59% fluoxetine alone responded (fluoxetine = Perez V, et al: Randomized, double-blind, placebo-controlled trial of pindolol in combination with fluoxetine antidepressant treatment. Lancet 97;349:1594)(paroxetine = Internatl Clin Psychopharm 97;12:81)

Pindolol No Help in DB of Rx Resistant: 80 patients MDD unresponsive to an SSRI had pindolol 2.5mg TID or placebo added for 10 days with absolutely no difference between groups. Arch Gen Psych ’99;56:375

Propranolol

Propranolol Appeared to Help Winter Depression: 60 pt open trial average 33mg/d AM then put in DB PC withdrawal with HAM-D increase 3 with propranolol and 11 with placebo. Early-morning administration of short-acting beta blockers for treatment of winter depression. Schlager DS. Am J Psychiatry 1994 Sep;151(9):1383-5

Other research has found that beta-blockers can actually increase depression, so this must be watched for.