Reboxetine

Brand name :REBOXXIN (Reboxetine, Edronax)

What is REBOXXIN (Reboxetine, Edronax) ?

Reboxetine is a noradrenaline reuptake inhibitor (NRI) that is licensed to treat depression. The brand name of Reboxetine is Edronax.

How does it work?

Reboxetine selectively inhibits the reuptake of the neurotransmitter noradrenaline from its site of action at the synaptic cleft. In doing so, reboxetine may prolong the actions of this neurotransmitters and it is likely that this may be the mechanism that underlies the therapeutic action. Reboxetine only has a weak effect on the reuptake of serotonin and does not affect the uptake of dopamine.

How well does it work?

The goal of antidepressant therapy is to achieve complete remission of symptoms. A response to treatment is often defined as at least a 50% reduction of depressive symptoms, and remission is a complete absence of symptoms.

At present there is no convincing evidence to suggest that any one antidepressant is more or less effective than any other antidepressant. (ref 1, 2) Choice is usually governed by differences in side effect profiles and by patient preference.

Not everyone who is prescribed an antidepressant will observe a benefit - response is only seen in about two-thirds of people who are prescribed antidepressants. Therefore most patients prescribed reboxetine will respond but some patients will not. Reboxetine should be taken for an adequate length of time (at least 4 weeks) before assessing whether there has been a response.

Who should take REBOXXIN (Reboxetine, Edronax) ?

Reboxetine is a useful antidepressant treatment for many people, including those with depression, dysthymia, depression plus a medical illness, or recurrent episodes of depression requiring long-term preventive treatment.

The cautions and contra-indications for using reboxetine, and its side effect profile (see next page) differ from that of the other groups of antidepressant, such as the tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) and may therefore affect choice.

The SSRIs are generally preferred to the TCAs in patients who are highly suicidal as they are safer in overdose. Reboxetine also appears to be relatively safe in overdose.

What is the dose REBOXXIN (Reboxetine, Edronax) ?

Reboxetine should be started at 4mg twice a day. Depending on individual response, the dose may be gradually increased to a maximum of 12 mg daily in divided doses.

What should patients do if they miss a dose?

Inadvertently missing one dose of reboxetine is unlikely to pose a problem. If the patient realises they have missed a dose they should take it as soon as they remember, providing it's not long after it's usually taken, otherwise they should omit the forgotten dose and continue taking the remaining doses at the correct time. Missing several doses of reboxetine may reduce symptom control and increase the likelihood of depressive relapse.