Reboxetine Versus Fluoxetine: An Overview of Efficacy and Tolerability

Serotonin selective reuptake inhibitors (SSRIs) are widely used to treat depression and offer theadvantage of being better tolerated compared with tricyclic antidepressants, which inhibit both serotoninand norepinephrine reuptake. Against this background, 2 clinical studies were conducted comparingthe 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, underinpatient 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 wassimilar, and superior to placebo, as assessed by the mean reduction in Hamilton Rating Scale forDepression total score. Reboxetine demonstrated superior efficacy compared with fluoxetine in severelyill patients and was associated with greater improvement in social functioning, especially interms 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 fluoxetinein the treatment of severely ill patients and in terms of improving social functioning.