Reboxetine Versus Fluoxetine: An Overview of Efficacy and Tolerability




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Serotonin selective reuptake inhibitors (SSRIs) are widely used to treat depression and offer the advantage of being better tolerated compared with tricyclic antidepressants, which inhibit both serotonin and norepinephrine reuptake. Against this background, 2 clinical studies were conducted comparing the efficacy and tolerability of reboxetine, a selective norepinephrine reuptake inhibitor, with fluoxetine, an SSRI. Both studies were of double-blind, randomized, parallel-group, multicenter design. One included a placebo control group. Five hundred forty-nine patients with major depression, under inpatient care or attending outpatient or day hospital clinics, received reboxetine (8–10 mg/day) or fluoxetine (20–40 mg/day) over 8 weeks. The overall efficacy of reboxetine and fluoxetine was similar, and superior to placebo, as assessed by the mean reduction in Hamilton Rating Scale for Depression total score. Reboxetine demonstrated superior efficacy compared with fluoxetine in severely ill patients and was associated with greater improvement in social functioning, especially in terms of motivation toward action and negative self-perception. Both treatments were well tolerated. In summary, reboxetine is an effective and well-tolerated antidepressant and is superior to fluoxetine in the treatment of severely ill patients and in terms of improving social functioning.

J Clin Psychiatry 1998;59(suppl 14):8–10