pindolol

Pindolol blocks both beta-1 and beta-2 receptors but acts as a partial agonist, producing less bradycardia and less reduction in cardiac output than pure beta-blockers. Its ISA makes it a poor choice for patients with ischemic heart disease, post-MI, or those needing rate control because adequate beta-blockade isn't achieved. Used primarily for hypertension, sometimes as an augmentation agent in depression (off-label, via 5-HT1A antagonism). Adverse effects: bronchospasm (nonselective), fatigue, vivid dreams, sexual dysfunction. Classic boards association: pindolol and acebutolol are the canonical ISA beta-blockers.