Reboxetine
Does it work?
Probably. There's some research showing that this newer antidepressant works as well as other drugs for people with severe depression. And reboxetine may be slightly better at helping with relationships and the social side of your life.
But this drug can cause unpleasant side effects.
What is it?
Reboxetine (brand name Edronax) is a fairly new antidepressant. It may be used after other antidepressants haven't worked. It's a type of antidepressant known as a selective inhibitor of noradrenaline reuptake.
Your doctor will probably talk to you about what treatment you would like, if any. There are national guidelines for doctors on how to treat depression.[1] You might find them useful when discussing your treatment with your doctor. To learn more, see NICE guidance on depression.
You'll probably need to take antidepressants for more than six weeks before you start to feel better. So it's important not to stop taking them early.
How can it help?
Reboxetine can help you with the symptoms of depression.
Between half and three-quarters of severely depressed people feel much better after treatment with reboxetine.[3] [4] [5] [6] Taking an antidepressant can mean:
- You feel less sad, hopeless, worried or guilty
- Your appetite improves
- Your sex drive comes back
- You can concentrate better
- You no longer think about suicide.
Reboxetine seems to work as well as other antidepressants. Studies show that just as many people with severe depression improve when taking reboxetine as when taking either a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI). But reboxetine may be slightly better at helping with relationships and the social side of your life.[7]
Why should it work?
Antidepressants affect chemicals called neurotransmitters which help carry messages from brain cell to brain cell. In particular, reboxetine boosts the amounts of the chemical noradrenaline. This gradually causes changes in how your brain cells behave. It can take several weeks before you can tell if the drug is affecting your mood.
The problem is that antidepressants also affect other brain cells, disrupting nerve signals and causing side effects.
Can it be harmful?
Around three-quarters of people who took reboxetine in studies had at least one side effect.[5] This is similar to the amount of side effects caused by other antidepressants.
Here's what happened to the people with depression who took reboxetine in studies.[3] [4] [5] [6]
- Between 13 in 100 and 57 in 100 people said they got a dry mouth.
- Up to a quarter had trouble sleeping.
- Between 4 in 100 and 18 in 100 had blurred vision.
- Between 10 in 100 and 21 in 100 got constipated.
- About 1 in 5 said they sweated more than usual.
- About 1 in 6 got headaches or migraines.
- About 1 in 7 got trembling hands.
- About 1 in 7 felt sick.
- Between 10 in 100 and 19 in 100 had low blood pressure.
- About 1 in 10 said they found it harder to pass urine.
Some side effects are more common if you take reboxetine than if you take other kinds of antidepressants.
- Studies show that people taking reboxetine may be more likely to have a dry mouth, constipation or low blood pressure, or find it harder to pass urine than people treated with a selective serotonin reuptake inhibitor (SSRI), such as fluoxetine (brand name Prozac).[6] But people taking fluoxetine are more likely to be nervous or anxious, or get diarrhoea.[6]
- You're more likely to get a headache and feel sick with reboxetine than with a tricyclic antidepressant (TCA). But other side effects are more common with TCAs. These include blurred vision, a dry mouth, trouble sleeping, low blood pressure and trembling hands.[4] [5]
All antidepressants can cause side effects. It's important to find the drug that suits you best.
Older people may be more likely to get side effects than younger people, whatever antidepressant they take. This is because of changes in the body that happen as people get older. Older people are also often taking other medicines, so there's more chance of side effects from using more than one drug.
Withdrawal symptoms
If you stop taking antidepressants suddenly you can get withdrawal symptoms, such as feeling sick, vomiting, getting headaches and having problems sleeping. To avoid these effects, your doctor should reduce your dose gradually over a few weeks.
Can I take antidepressants if I'm pregnant?
There isn't much research on taking antidepressants if you're pregnant. Doctors are advised to avoid prescribing them to pregnant women, or to use them with care if the benefits are likely to outweigh the risks.[2] This is because of concerns that drugs taken during pregnancy might harm the baby. However, some research shows that pregnant women who stop taking their antidepressants are more likely to become depressed again.[8]
To learn more, see Antidepressants and pregnancy.
References
- National Institute for Clinical Excellence. Depression: management of depression in primary and secondary care. December 2004. NICE clinical guideline 23. Available at http://www.nice.org.uk/cg023 (accessed on 12 July 2007).
- British National Formulary. Pregnancy. BNF 53. March 2007. Appendix 4. British Medical Association and Royal Pharmaceutical Society of Great Britain. Also available at http://bnf.org (accessed 5 June 2007).
- Versiani M, Amin M, Chouinard G. Double-blind, placebo-controlled study with reboxetine in inpatients with severe major depressive disorder. Journal of Clinical Psychopharmacology. 2000; 20: 28-34.
- Ban TA, Gaszner P, Aguglia E, et al. Clinical efficacy of reboxetine: a comparative study with desipramine, with methodological considerations. Human Psychopharmacology. 1998; 13 (supplement): S29-S39.
- Berzewski H, Van Moffaert M, Gagiano CA. Efficacy and tolerability of reboxetine compared with imipramine in a double-blind study in patients suffering from major depressive. European Neuropsychopharmacology. 1997; 7 (supplement 1): S37-S47.
- Massana J, Moller H-J, Burrows GD, et al. Reboxetine: a double-blind comparison with fluoxetine in major depressive disorder. International Clinical Psychopharmacology. 1999; 14: 73-80.
- Dubini A, Bosc M, Polin V. Noradrenaline-selective versus serotonin-selective antidepressant therapy: differential effects on social functioning. Journal of Psychopharmacology. 1997; 11 (supplement): S17-S23.
- U.S. Food and Drug Administration. Treatment challenges of depression in pregnancy. Available at http://www.fda.gov/cder/drug/advisory/SSRI_PPHN200607.htm (accessed on 21 July 2006).
Glossary
- noradrenaline
- A neurotransmitter, which is a chemical that sends information from a nerve cell to other cells. It is similar in structure and effect to adrenaline, which the body produces in response to stressful situations to increase blood pressure and heart rate.
- constipated
- When you're constipated, you have difficulty passing stools (faeces). Your bowel movements may be dry and hard. You may have fewer bowel movements than usual, and it may be a strain when you try to go.
- diarrhoea
- Diarrhoea is when you have loose, watery stools and you need to go to the toilet far more often than usual. Doctors say you have diarrhoea if you need to go to the toilet more than three times a day.
- withdrawal symptoms
- Withdrawal symptoms are when you get unpleasant physical or mental symptoms because you stopped taking a drug you were physically dependent on. Your can become physically dependent on a drug if it alters the level of certain chemicals in your body. This makes your body produce less of those chemicals or change how it responds to them. Also, some drugs work in a similar way to chemicals that naturally occur in your body. This may mean your body stops making its natural versions. If either of those things happens, your body will need the drug to function normally and you will feel or become ill if you suddenly stop taking the drug. You can get withdrawal symptoms from some prescription medicines, as well as some illegal drugs.
- low blood pressure
- If your blood pressure is about 100/60 or less, your doctor may say that you have low blood pressure. Low blood pressure is usually not a problem unless it becomes too low to push blood to your brain and the rest of the body. If you have low blood pressure, you may sometimes feel dizzy when you stand up. To find out what these numbers mean, see .
- migraine headaches
- These are severe headaches that last four to 72 hours. They often cause other symptoms such as queasiness (nausea) or being extra-sensitive to sound or light.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
