Chairman's overview. The place of reboxetine in antidepressant therapy

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.