Reboxetine: additional benefits to the depressed patient

Reboxetine is a new selective noradrenaline reuptake inhibitor that has been shown to be effective in both the short-(4-8 weeks) and long-term (up to 12 months) treatment of depression. Four positive placebo-controlled studies showed reboxetine to have significant antidepressant efficacy; the response rate (> or = 50% decrease in HAM-D total score) with reboxetine ranging from 56-74%. Comparator-controlled trials showed reboxetine to be at least as efficacious as imipramine and desipramine in both adults and elderly patients. Reboxetine is also as effective as fluoxetine in the overall depressed population. However, subset analysis showed reboxetine to be significantly superior to fluoxetine in severely depressed patients. Reboxetine also showed significant advantages over fluoxetine in terms of social functioning, positively affecting patients' self perception and motivation towards action. The therapeutic effect of reboxetine is maintained for at least up to 1 year. During long-term therapy, 78% of patients receiving reboxetine were in remission at last assessment compared with only 45% of patients in the placebo group. Fewer reboxetine-treated patients relapsed (22%) compared with those receiving placebo (56%). In summary, reboxetine is effective in both the short- and long-term treatment of depression, and is at least as efficacious as traditional tricyclic antidepressant drugs and selective serotonin reuptake inhibitors. The additional benefits offered by reboxetine to the depressed patient include effective long-term treatment, efficacy in all grades of depression (including severe cases) and, importantly, specific advantages on social functioning. These additional benefits make reboxetine a favourable choice in the management of depression.