Chairman's overview.
The place of reboxetine in antidepressant therapy
Montgomery SA
Imperial College of Medicine at St Mary's, London, UK.
J Clin Psychiatry 1998; 59 Suppl 14:26-9
ABSTRACT
A comprehensive series of clinical trials have
compared the unique selective NRI reboxetine with placebo and with the TCAs
imipramine and desipramine, as well as with the SSRI fluoxetine. Reboxetine
is clearly effective in both the short and the long term compared with
placebo. Against comparator antidepressants, reboxetine is at least as
effective in the treatment of patients with major depressive disorder in the
adult and the elderly population and offers a significant advantage over
imipramine in the treatment of melancholic patients. In severely depressed
patients, reboxetine was significantly more effective than fluoxetine.
Reboxetine also offers significant advantages over fluoxetine in terms of
social functioning and has a significantly improved adverse event profile
compared with TCAs. In comparison with fluoxetine, reboxetine has a
different adverse event profile, but shows advantages in terms of
agitation/nervousness/anxiety and gastrointestinal events. Reboxetine is not
cardiotoxic, and it is not associated with an increased risk of seizures or
of orthostatic hypotension. Overall, reboxetine offers a significant safety
advantage over TCAs in the treatment of the depressed population and in
subsets of the depressed population in an efficacy comparison with the SSRI
fluoxetine.
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