Reboxetine – a ‘NaRI’ Clarify desipramine
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چکیده
Where is its place in therapy? ! There is no convincing evidence to suggest an overall advantage in efficacy, relapse prevention or speed of onset with reboxetine over existing antidepressants. ! It may be useful in SSRI resistant depression. More evidence is needed to support its use in indications such as anxiety, OCD and panic disorder. ! Noradrenergic deficiency differs to serotonergic deficiency and is associated with impaired attention, problems concentrating, fatigue and memory deficits. These symptoms may respond best to treatment with a selective noradrenergic agent, such as reboxetine. ! Like the SSRIs, reboxetine offers advantages over the tricyclics and the MAOIs in terms of safety. ! Unlike the SSRIs & TCAs it does not significantly interact with cytochrome P450 enzymes. ! Reboxetine is associated with “pseudo-anticholinergic” symptoms (not due to direct action on cholinergic receptors). This may preclude its use in certain patients.
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