Reboxetine, a New Noradrenaline Selective Antidepressant, Is at Least as Effective as Fluoxetine in the Treatment of Depression

Abstract

The clinical profile of reboxetine, a selective noradrenaline reuptake inhibitor, was compared with that of the selective serotonin reuptake inhibitor fluoxetine and placebo in a double-blind, multicenter, parallel-group clinical trial of patients with major depression. Among the 381 patients treated with reboxetine 8 to 10 mg/day, fluoxetine 20 to 40 mg/day, or placebo for up to 8 weeks, a statistically significant greater reduction in the mean Hamilton Rating Scale for Depression (21-item HAM-D) total score (the primary efficacy variable) was seen for both active treatment groups compared with placebo (p < 0.024). A significantly greater proportion of patients treated with either reboxetine or fluoxetine also achieved a response (>or=50% reduction in HAM-D) or remission (HAM-D <or=10 points) than those who received placebo (p < 0.01 for both analyses). Similar findings were recorded in a subpopulation of severely ill patients, with statistically significantly greater decreases in the mean HAM-D total score between both active treatment groups compared with placebo (p < 0.024). Additional efficacy assessments (Montgomery-Asberg Depression Rating Scale, Clinical Global Impression) reflected the primary efficacy analysis, with both active treatments offering comparable efficacy that was superior to that of placebo. Reboxetine and fluoxetine are more effective than placebo in the treatment of major depression. Futhermore, both antidepressants are well tolerated but possess different adverse event profiles.

Behavioral Effects of Chronic Fluoxetine in BALB/cJ Mice Do Not Require Adult Hippocampal Neurogenesis or the Serotonin 1A Receptor

“…Our results suggest the presence of strain-dependent mechanisms underlying the antidepressant response. The onset of the therapeutic effects of antidepressant drugs in patients exhibits a characteristic delay of several weeks (Andreoli et al, 2002;De Nayer et al, 2002;Blier, 2003). The traditional FST is a reliable assay with strong predictive validity for antidepressant compounds that assesses the behavioral response to acute drug treatment.…”

“…However, a significant proportion of nonresponsive patients (Kampf-Sherf et al, 2004), and a delay of 2-4 weeks before therapeutic efficacy is apparent (Andreoli et al, 2002;De Nayer et al, 2002;Blier, 2003) impair the treatment of depression. A better understanding of the mechanisms underlying antidepressant efficacy may permit the development of novel treatments with greater efficacy and faster onset.…”

Interventions for management of post-stroke depression: A bayesian network meta-analysis of 23 randomized controlled trials

“…Preclinical and clinical observations indicated that reboxetine has high affinity and selectivity for norepinephrine (NE) transporters [17][18][19] . A review suggested that with its remarkable selectivity to NE over serotonin transporters, reboxetine is a rational alternative for patients who are resistant to conventional antidepressants, such SSRIs and TCAs 17 .…”

Comparison of efficacy and tolerability of reboxetine and venlafaxine XR in major depression and major depression with anxiety features: an open label study

“…Results from placebo-controlled trials suggest that reboxetine is significantly superior to placebo in treating major depression (Massana, 1998;Versiani et al, 1999Versiani et al, , 2000Andreoli et al, 2002). Reboxetine was also compared to imipramine (Berzewski et al, 1997), desipramine (Ban et al, 1998) and fluoxetine (Massana et al, 1999), and was found to be as effective as these comparators in treating MDD.…”