Reboxetine, a selective noradrenaline reuptake inhibitor, is non-sedative and does not impair psychomotor performance in healthy subjects

Abstract

A double-blind, randomized, four-way crossover study was performed to assess the CNS eects of reboxetine, a unique selective noradrenaline reuptake inhibitor (NRI). Eighteen volunteers received reboxetine (1 or 3 mg), imipramine (75 mg) or placebo at weekly intervals. Pharmaco-electroencephalography was recorded under high-and low-vigilance conditions and spectral dierence index, total power and alpha slow-wave index (ASI) were calculated. In addition, skilled performance on psychometric tests and well-being were assessed. Absolute and relative power were relatively unaected by reboxetine but increased by imipramine. Total power and ASI were unaected or slightly increased by reboxetine, but reduced by imipramine. Reboxetine and imipramine decreased fronto-central W and fast b power. In pharmaco-electroencephalography, imipramine showed a left shift in the occipito-temporal lead, with an increase in d and W and a decrease in a power. Reboxetine increased a power. Following reboxetine administration, the results in performance tests either did not dier from placebo or were better (Pegboard test). After imipramine, a deterioration in the Steadiness and Pauli test occurred. Critical¯icker fusion and Vienna test results were unaltered by either drug. In summary, reboxetine, unlike the tricyclic antidepressant imipramine, has no sedative eects of electroencephalography or on any behavioural variable indicative of a decline in vigilance. Furthermore, reboxetine showed a vigilance-enhancing eect. #

The effects of noradrenergic re-uptake inhibition on memory encoding in man

“…Based on this evidence, it is possible that reboxetine, in higher doses, while highly selective for the noradrenergic system, may produce anticholinergic side effects which may impair cognitive functioning. No cognitive or psychomotor impairments have been observed with reboxetine in some clinical studies (Kerr et al 1996) or in studies of healthy subjects (Herman and Fuder 1998). However, these studies did not use doses exceeding 4 mg. More evidence is required concerning the effects on cognitive functioning in healthy adults of doses equivalent to the recommended daily dose for adults suffering from depressive illness (8 mg/day).…”

“…Accordingly, few effects on heart rate and blood pressure were expected. Furthermore, no cognitive or psychomotor impairments have been observed with reboxetine in clinical studies (Kerr et al 1996), or in studies with healthy adults (Herman and Fuder 1998) making it a good candidate for use in the assessment the role of the noradrenergic system in memory functioning.…”

Difference in serotonergic and noradrenergic regulation of human social behaviours

“…A reduction in this behaviour might be a sign of alertness to the new environment or a reduction in anxiety. Acute reboxetine treatment has been found to enhance alertness (Herrmann and Fuder 1999) and reduce anxiety (Phillips et al 2000). These effects might represent supportive evidence for the hypotheses that heightened noradrenergic activity is associated with increased reactivity and engagement in the environment (Coccaro and Siever 1995) or increased vigilance, energy and interest (Healy and McMonagle 1997).…”

Reboxetine: the first selective noradrenaline re-uptake inhibitor

“…In contrast, reboxetine does not appear to have any greater effect on psychomotor or cognitive performance than placebo, even when combined with alcohol [36]. Furthermore, no sedative effects have been observed and reboxetine may in fact confer a vigilance-enhancing effect [37].…”