Pindolol

Pindolol, sold under the brand name Visken among others, is a nonselective beta blocker which is used in the treatment of hypertension and angina pectoris. It is also an antagonist of the serotonin 5-HT1A receptor, preferentially blocking inhibitory 5-HT1A autoreceptors, and has been researched as an add-on therapy to selective serotonin reuptake inhibitors (SSRIs) in the treatment of depression. Pindolol, sold under the brand name Visken among others, is a nonselective beta blocker which is used in the treatment of hypertension and angina pectoris. It is also an antagonist of the serotonin 5-HT1A receptor, preferentially blocking inhibitory 5-HT1A autoreceptors, and has been researched as an add-on therapy to selective serotonin reuptake inhibitors (SSRIs) in the treatment of depression. Pindolol is used for hypertension in the United States, Canada, and Europe, and also for angina pectoris outside the United States. When used alone for hypertension, pindolol can significantly lower blood pressure and heart rate, but the evidence base for its use is weak as the number of subjects in published studies is small. In some countries, pindolol is also used for arrhythmias and prophylaxis of acute stress reactions. Similar to propranolol with an extra contraindication for hyperthyroidism. In patients with thyrotoxicosis, possible deleterious effects from long-term use of pindolol have not been adequately appraised. Beta-blockade may mask the clinical signs of continuing hyperthyroidism or complications, and give a false impression of improvement. Therefore, abrupt withdrawal of pindolol may be followed by an exacerbation of the symptoms of hyperthyroidism, including thyroid storm. Pindolol has modest beta-adrenergic agonist activity and is therefore used with caution in angina pectoris. Pindolol is a non-selective beta blocker or β-adrenergic receptor antagonist with partial agonist activity and also possesses intrinsic sympathomimetic activity. This means that pindolol, particularly in high doses, exerts effects like epinephrine (adrenaline) or isoprenaline (increased pulse rate, increased blood pressure, bronchodilation), but these effects are limited. Pindolol also shows membrane-stabilizing effects like quinidine, possibly accounting for its antiarrhythmic effects. It also acts as a serotonin 5-HT1A receptor weak partial agonist (intrinsic activity = 20–25%) or functional antagonist.