Esreboxetine

DescriptionReboxetine is a pure noradrenaline reuptake inhibitor that is licensed as an antidepressant in the United Kingdom. Reboxetine has established efficacy based on placebo-controlled studies both in the short and the long term. Previous noradrenaline reuptake inhibitors, such as desipramine, nortriptyline, and maprotiline, have been relatively selective for noradrenaline compared with serotonin but have not avoided affinities with α1, muscarinic, and histaminergic receptors. The lack of selectivity of these drugs has the consequence that the levels of cardiotoxicity are those expected with TCAs. Reboxetine is the first pure noradrenaline reuptake inhibitor, and therefore it may also provide a more appropriate agent to consider for the investigation of possible adjunctive treatments with SSRIs.

UsesReboxetine can be used in biological study of the involvement of monoaminergic neurotransmission in the antidepressant-like action of scopolamine in the tail suspension test.

General DescriptionMost of the activity of reboxetine resides in the S,S-isomer(The marketed compound is RR and SS.) It is claimed to besuperior to fluoxetine in severe depression. It is marketed inEurope. At least three tricyclic compounds, desipramine,nortriptyline, and the technically tetracyclic maprotiline areSNERIs. They, of course, have typical characteristic TCAside effects but lower anticholinergic and H1-antihistaminic(sedative) effects than dimethyl compounds. SNERIs areclinically effective antidepressants.It would be expected that in the case of SNERIs,α2presynaptic receptors would be desensitized, after whichsustained NE transmission would be via one or more postsynapticreceptors; α1, β1, and β2 receptors are possibilities.