Reboxetine combination in treatment-resistant depression to selective serotonin reuptake inhibitors.

Abstract

INTRODUCTION:

Treatment-resistant depression is a relatively common clinical occurrence: between 60-70% of depressive patients fail to achieve total remission to the initial treatment with selective serotonin reuptake inhibitors (SSRI).

METHODS:

In this prospective 12-week open-label study, we evaluated the effectiveness of the addition of reboxetine to 141 outpatients diagnosed with major depressive disorder, according to DSM-IV-TR criteria, who were partial responders or non-responders over a period of 6 weeks, to previous treatment in monotherapy with SSRI. Evaluation of antidepressant efficacy was carried out through the application of the Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impressions-Global Improvement Scale (CGI-I). Data were analyzed on an intent-to-treat basis, using the last-observation-carried-forward method.

RESULTS:

Mean score on the HDRS at baseline was 26.24+/-7.21, falling to 13.96+/-8.00 in week 12 (mean decrease of 46.79%; p<0.0001) The percentages of responders (HDRS total score > or =50%) and patients considered as benefiting from complete remission (HDRS score < or =10) at 12 weeks were 50.4% and 34.5%, respectively. By the end of the treatment, a mean decrease in CGI-I score of 1.88 points was obtained (41.14% of reduction; p<0.0001), and 77% of the patients were evaluated as improved (CGI-I score <4). Nervousness was the adverse effect most frequently reported (5.21%), followed by dryness of mouth (4.38%), and insomnia (3.56%).

CONCLUSION:

The results of this study suggest that the combination strategy with reboxetine appears to be a potentially useful tool in cases of SSRI-resistant depression.

• Authors: F López-Muñoz, C Alamo, G Rubio, P García-García, A Pardo
• Journal: Pharmacopsychiatry (Pharmacopsychiatry) Vol. 40 Issue 1 Pg. 14-9 (Jan 2007) ISSN: 0176-3679 [Print] Germany
• PMID: 17327955 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Antidepressive Agents
• Morpholines
• Serotonin Uptake Inhibitors
• Reboxetine

Topics

• Adult
• Antidepressive Agents (therapeutic use)
• Depressive Disorder, Major (drug therapy, psychology)
• Drug Resistance
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Morpholines (therapeutic use)
• Prospective Studies
• Psychiatric Status Rating Scales
• Reboxetine
• Selective Serotonin Reuptake Inhibitors (therapeutic use)