Reboxetine side effects

However, these side effects can be experienced with reboxetine or atomoxetine. Although they are seldom severe, one may need to take steps to remedy the side effects. The first step is to use the smallest effective dose. When this fails, using a second medication such as a benzodiazepine to counteract sleep difficulties or anxiety can be tried. However, without compelling reasons to stay with one of these medications, the best remedy is often to change to a different antidepressant. 

Reboxetine is the only selective and reasonably potent noradrenaline reuptake inhibitor available clinically at the present time. Reboxetine has a chemical structure not dissimilar from viloxazine, an antidepressant which was of only limited clinical interest in the 1970s because of its weak efficacy and unacceptable side effects (nausea, vomiting and occasionally seizures). Unlike the secondary amine TCA antidepressants, such as maprotiline, desipramine, nortriptyline and protriptyline, reboxetine does not affect any other transporter or receptor system and therefore is largely devoid of TCA and SSRI-like side effects. In clinical trials, reboxetine has been shown to be as effective as the SSRIs in the... 

Side effects may appear anticholinergic , but reboxetine does not directly block muscarinic receptors... 

Reboxetine. Most of the activity of rehoxetine resides in the 5.5 isomer (The marketed compound is RR and 55.) It is claimed to he superior to fluoxetine in severe depression. It is marketed in Europe. At least three tricyclic compounds, desipramine. nortriptyline, and the technically tetracyclic maprotiline are SNERIs. They, of course, have typical characteristic TCA side effects but lower anticholinergic and H -antihistaminic (sedative) effects than dimethyl compounds. SNERIs arc clinically effective antidepressants. 

Reboxetine. Reboxetine (21) is a norepinephrine-selective reuptake inhibitor that lacks affinity for most of the monoamine receptors. It thus does not exhibit the typical side-effect profile of the tricyclics. Nevertheless, side effects include increased sweating, postural hypotension (leading to dizziness), dry mouth, constipation, blurred vision, impotence, and dysuria. Tachycardia and urinary retention have also been reported (59). There is no evidence of cardiotoxicity and sexual dysfunction seems to be rare. In contrast to some of the earlier tricyclics that are sedative, reboxetine is nonsedating and can cause insomnia (60,61).. 

Reboxetine is a nontricyclic SNRI in which the propylamine side chain of the TCAs is constrained into a morpholine ring (Fig. 21.8). It is a potent and selective ligand for the NET, with a mechanism of action is similar to that of desipramine. Reboxetine is used for the treatment of major depressive disorders. It is a chiral compound that is marketed as a racemic mixture of R,R- and S,S-reboxetine. The antidepressant activity for reboxetine appears to reside with the S,S-(+)-enantiomer, which has approximately twofold the inhibition potency of the R,R-enantiomer (42). It is well tolerated, with different adverse-event profiles, and it appears to be at least as effective as the SSRIs in the treatment of depressive illness. Currently, it is available only in Europe and is under U.S. FDA review. It preferentially inhibits the reuptake of NE (5-FIT NE ratio, 8). Reboxetine is not metabolized by the polymorphic isoforms, CYP2D6 or CYP2C19, and may offer a valuable alternative to the secondary amine TCAs in the treatment of major depression. Reboxetine is likely to become a promising alternative for patients who have failed treatment with or do not tolerate serotonergic antidepressants. Reboxetine has been shown to be effective and well tolerated in the treatment of panic... 

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