Reboxetine, a selective noradrenaline reuptake inhibitor for the treatment of depression.

: Reboxetine is a selective noradrenaline reuptake inhibitor that has been found to be efficacious and tolerable in both short- and long-term treatment of depression. It is a racemic mixture of two enantiomers, the (S,S)-enantiomer being the more potent inhibitor. Reboxetine has little effect on 5-HT or dopamine reuptake, does not inhibit monoamine oxidase activity and has low affinity for alpha-adrenergic and muscarinic receptors. Absorption is rapid and the terminal elimination half-life (13 h) allows twice-daily administration. It shows linear pharmacokinetics which are unaffected by multiple dosing, gender or hepatic insufficiency, although doses should be reduced in elderly patients and in those with severe renal impairment. Reboxetine does not interact with the principal isotypes of the cytochrome P450 system and should have a low potential for drug-drug interactions. Studies in animal models indicate that it has low toxicity.