Q. I would like to ask your opinion of the following: Desyrel and Visken (or Pindolol)

I am interested to know your opinion of Desyrel, and the use of Visken as a Paxil "booster." My GP prescribed both of these drugs along with Paxil, now at 40mg, and Flexeril. I have accumulated these prescriptions over the years of visiting my GP, and they have been prescribed for symptoms like depression, or sleeplessness, not for BPD. That diagnosis was made by a psychologist.

  A. There is some clinical data to support both drugs as add ons for treatment. Pindolol, in studies from a few locations, has been shown to lower the time of onset of antidepressant effects. It has not been shown to make a previously ineffective antidepressant work. That is, it can make Paxil work faster when it is first started, but not make Paxil work if your results to date are unsatisfactory.

Trazodone (Desyrel) is usually used to help with sleep, but some data suggests it can augment other antidepressant. In this case, make them work if they were not prior to Trazodone. In these cases, I try to use Serzone as 500-750 mg at bedtime to treat the disease, and eliminate the SRI. Talk it over with your doctor, he sounds very knowledgeable.