REBOXETINE VERSUS FLUOXETINE - AN OVERVIEW OF EFFICACY AND TOLERABILITY

Serotonin selective reuptake inhibitors (SSRIs) are widely used to tre at depression and offer the advantage of being better tolerated compar ed with tricyclic antidepressants. which inhibit both serotonin and no repinephrine reuptake. Against this background, 2 clinical studies wer e conducted comparing the efficacy and tolerability of reboxetine, a s elective norepinephrine reuptake inhibitor, with fluoxetine, an SSRI. Both studies were of double-blind, randomized, parallel-group, multice nter design. One included a placebo control group. Five hundred forty- nine patients with major depression, under inpatient care or attending outpatient or day hospital clinics, received reboxetine (8-10 mg/day) or fluoxetine (20-40 mg/day) over 8 weeks. The overall efficacy of re boxetine and fluoxetine was similar, and superior to placebo, as asses sed by the mean reduction in Hamilton Rating Scale for Depression tota l score. Reboxetine demonstrated superior efficacy compared with fluox etine in severely ill patients and was associated with greater improve ment in social functioning, especially in terms of motivation toward a ction and negative self-perception. Both treatments were well tolerate d. In summary, reboxetine is an effective and well-tolerated antidepre ssant and is superior to fluoxetine in the treatment of severely ill p atients and in terms of improving social functioning.