Posted by jono_in_adelaide on October 31, 2011, at 19:47:19
There have been a few posts poo pooing reboxetine as an useless drug etc of late, which I think is unfair.
I found the following in the british National Institute for Clinical Excelence evidence guidelines for major depression"
Given its noradrenalin profile, reboxetine is likely to be more useful in the rarer endrogenous deep depressions, where as the SSRI's and Effexor are more likely of use in the neurotic and atypical type depressions - I think reboxetines place is as a second line agent, when an SSRI doesnt work, or as an addition to the SSRI's in difficult to treat cases.
Personaly i found it as good as nortriptyline and bupropion.
"Clinical evidence statements for reboxetine compared with placebo130
Effect of treatment on efficacy outcomes
There is strong evidence suggesting that there is a clinically important difference
favouring reboxetine over placebo on increasing the likelihood of achieving a 50%
reduction in symptoms of depression as measured by the HRSD (K 3; N 479;
RR 0.61; 95% CI, 0.51 to 0.73).
There is some evidence suggesting that there is a clinically important difference
favouring reboxetine over placebo on increasing the likelihood of achieving remission
by the end of treatment (K 1; N 254; RR 0.71; 95% CI, 0.59 to 0.87).
Acceptability and tolerability of treatment
There is insufficient evidence to determine whether there is a clinically important
difference between reboxetine and placebo on any measure of acceptability or
tolerability.
Clinical evidence statements for reboxetine compared with other antidepressants131
Effect of treatment on efficacy outcomes
There is evidence suggesting that there is no clinically important difference between
reboxetine and other antidepressants on:
● increasing the likelihood of achieving a 50% reduction in symptoms of depression
as measured by the HRSD (K 5; N 1068; RR 0.87; 95% CI, 0.76 to 1.01)
Pharmacological interventions
379
128Details of standard search strings used in all searches are in Appendix 8. Information about each study
along with an assessment of methodological quality is in Appendix 17c, which also contains a list of
excluded studies with reasons for exclusions.
129Study IDs in title case refer to studies included in the previous guideline. References for these studies
are in Appendix 18.
130The forest plots can be found in Appendix 19c.
131The forest plots can be found in Appendix 19c.
● increasing the likelihood of achieving remission by the end of treatment (K 4;
N 895; RR 0.96; 95% CI, 0.84 to 1.09)
● reducing symptoms of depression by the end of treatment as measured by the
HRSD or MADRS (K 3; N 618; SMD 0.09; 95% CI, 0.24 to 0.07).
Acceptability and tolerability of treatment
There is evidence suggesting that there is no clinically important difference between
reboxetine and other antidepressants on increasing the likelihood of patients reporting
side effects (K 4; n 895; RR 0.98; 95% CI, 0.9 to 1.06).
There is insufficient evidence to determine whether there is a clinically important
difference between reboxetine and other antidepressants on reducing the likelihood of
leaving treatment early for any reason or on reducing the likelihood of leaving treatment
early due to side effects.
Clinical summary
Reboxetine is superior to placebo and as effective as other antidepressants in the treatment
of depression. There is insufficient evidence to comment on reboxetines tolerability
compared with placebo or alternative antidepressants.
poster:jono_in_adelaide
thread:1001353
URL: http://www.dr-bob.org/babble/20111027/msgs/1001353.html