Clinical efficacy of reboxetine in major depression

The past decade has witnessed the advent of selective serotonin reuptake in hibitors (SSRIs) as first-line treatments for major depression. Still, ther e is considerable debate as to whether these agents are as effective or as potent as the first-generation tricyclic antidepressants (TCAs) or the mixe d reuptake inhibitor. venlafaxine, all of which exert considerable effect o n norepinephrine (NE) reuptake. Recently, reboxetine, a selective NE reupta ke inhibitor (selective NRI), has been introduced in Europe. This drug has only a minimal affinity for muscarinic acetylcholine receptors and therefor e causes less dry mouth, constipation, or other such effects than do the TC As. Reboxetine does not block serotonin reuptake or alpha(1) receptors and, thus, does not appear to produce significant nausea, diarrhea, or hypotens ion. Unlike other antidepressants, reboxetine appears to be nonsedating. Da ta on acute and long-term clinical efficacy and safety from double-blind, p lacebo-controlled, and active comparator studies with reboxetine are review ed. These studies indicate that reboxetine is significantly more effective than placebo and as effective as fluoxetine in reducing depressive symptoms . Improvements in social adjustments were reported to be more favorable wit h reboxetine than with fluoxetine. Further, data from controlled clinical t rials have shown that the side effect profile for reboxetine is relatively benign. The clinical implications of studies on reboxetine are discussed wi th an eve toward understanding the potential role NE reuptake blockers may play in the treatment of patients with major depression.