Reboxetine Combination in Treatment-resistant Depression to Selective Serotonin Reuptake Inhibitors

López-Muñoz, Francisco; Álamo, Cecilio; Rubio, Gabriel; García-García, Pilar; Pardo, Antonio

doi:10.1055/s-2007-958523

Cited by 15 publications

(9 citation statements)

References 31 publications

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“…Based on those studies in humans and the experimental data cited above [46] , we propose that non-serotonergic (e.g., noradrenergic) pathways might elicit a more robust elevation of BDNF concentrations in human serum than selective serotonergic substances which could even decrease BDNF levels or, alternatively, that the noradrenergic component of amitriptyline strongly enhances BDNF expression by serotonergic mechanisms. This is in line with studies suggesting that reboxetine augmentation is useful in depressed patients not achieving remission by SSRI treatment alone [36] . However, to our knowledge there is only one study in humans (a purely female patient sample) demonstrating an increase in serum BDNF by a selective serotonergic antidepressant alone [4] .…”

Section: Discussionsupporting

confidence: 85%

Serum Concentrations of Nerve Growth Factor and Brain-Derived Neurotrophic Factor in Depressed Patients before and after Antidepressant Treatment

Hellweg

Ziegenhorn²,

Heuser³

et al. 2008

Pharmacopsychiatry

115

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Section: Discussionsupporting

confidence: 85%

Serum Concentrations of Nerve Growth Factor and Brain-Derived Neurotrophic Factor in Depressed Patients before and after Antidepressant Treatment

Hellweg

Ziegenhorn²,

Heuser³

et al. 2008

Pharmacopsychiatry

115

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“…Recent studies have suggested the suitability of combining SSRI with reboxetine (Devarajan and Dursun, 2000;Hawley, et al, 2000;Lucca, et al, 2000;Serretti, et al, 2001;Rubio, et al, 2003Rubio, et al, , 2004López-Muñoz, et al, 2007), having obtained highly promising results. Furthermore, there are no published data on the effectiveness of the combination strategy in patients who fail to respond to duloxetine, except a reports of sporadic cases of positive response to the addition of bupropion (n = 3) (Papakostas, et al, 2006), and mirtazapine (n = 5) (Ravindran, et al, 2008).…”

Section: Discussionmentioning

confidence: 95%

Effects of adjunctive reboxetine in patients with duloxetine-resistant depression: a 12-week prospective study

et al. 2009

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The efficacy of the combination therapy with two antidepressants from different pharmacological families in patients with treatment-resistant depression has been reported in multiple studies. In this prospective 12-weeks open-label study, we assessed the effectiveness of the addition of reboxetine to 79 depressive outpatients diagnosed with major depressive disorder (MDD) according to the DSM-IV criteria who had previously not responded, or had done so only in a partial way, over 8 weeks of conventional treatment, in monotherapy, with duloxetine. Efficacy was assessed using the 21-item Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impression-Improvement (CGI-I). Safety was evaluated by recording spontaneously reported adverse events. Data were analysed on an intent-to-treat basis, using the last-observation-carried-forward method. Mean HDRS reduction was 65.5% (P < 0.0001). The percentages of responders (>or=50% reduction in HDRS) and patients considered benefiting from complete remission (HDRS

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“…SNRIs show greater efficacy than SSRIs overall, and have a broader therapeutic range (e.g., against neuropathic pain), but their advantages are not dramatic and may be offset by other factors, such as an enhanced risk of hypertension. 3,35,37,38,275 In fact, rather inconveniently, the SSRI escitalopram appears to be equivalent in efficacy to SNRIs-although perhaps reflecting its distinctive multisite interaction with 5-HT transporters. 276,277 By analogy, mirtazapine (which has antagonist properties at ␣ 2 -ARs, 5-HT 2C , and 5-HT 3 receptors) is more effective than selective ␣ 2 -AR or 5-HT 3 antagonists, but it remains unknown how it compares with a selective 5-HT 2C antagonist in the clinic.…”

Section: A Valedictory Caveatmentioning

confidence: 99%

Dual- and Triple-Acting Agents for Treating Core and Co-morbid Symptoms of Major Depression: Novel Concepts, New Drugs

Millan¹

2009

Neurotherapeutics

180

123

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Summary:The past decade of efforts to find improved treatment for major depression has been dominated by genomedriven programs of rational drug discovery directed toward highly selective ligands for nonmonoaminergic agents. Selective drugs may prove beneficial for specific symptoms, for certain patient subpopulations, or both. However, network analyses of the brain and its dysfunction suggest that agents with multiple and complementary modes of action are more likely to show broad-based efficacy against core and comorbid symptoms of depression. Strategies for improved multitarget exploitation of monoaminergic mechanisms include triple inhibitors of dopamine, serotonin (5-HT) and noradrenaline reuptake, and drugs interfering with feedback actions of monoamines at inhibitory 5-HT 1A , 5-HT 1B and possibly 5-HT 5A and 5-HT 7 receptors. Specific subsets of postsynaptic 5-HT receptors mediating antidepressant actions are under study (e.g., 5-HT 4 and 5-HT 6 ). Association of a clinically characterized antidepressant mechanism with a nonmonoaminergic component of activity is an attractive strategy. For example, agomelatine (a melatonin agonist/5-HT 2C antagonist) has clinically proven activity in major depression. Dual neurokinin 1 antagonists/5-HT reuptake inhibitors (SRIs) and melanocortin 4 antagonists/SRIs should display advantages over their selective counterparts, and histamine H 3 antagonists/SRIs, GABA B antagonists/SRIs, glutamatergic/SRIs, and cholinergic agents/SRIs may counter the compromised cognitive function of depression. Finally, drugs that suppress 5-HT reuptake and blunt hypothalamo-pituitary-adrenocorticotrophic axis overdrive, or that act at intracellular proteins such as GSK-3␤, may abrogate the negative effects of chronic stress on mood and neuronal integrity. This review discusses the discovery and development of dual-and tripleacting antidepressants, focusing on novel concepts and new drugs disclosed over the last 2 to 3 years.

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Reboxetine Combination in Treatment-resistant Depression to Selective Serotonin Reuptake Inhibitors

Abstract: The results of this study suggest that the combination strategy with reboxetine appears to be a potentially useful tool in cases of SSRI-resistant depression.

Cited by 15 publications

References 31 publications

Serum Concentrations of Nerve Growth Factor and Brain-Derived Neurotrophic Factor in Depressed Patients before and after Antidepressant Treatment

Serum Concentrations of Nerve Growth Factor and Brain-Derived Neurotrophic Factor in Depressed Patients before and after Antidepressant Treatment

Effects of adjunctive reboxetine in patients with duloxetine-resistant depression: a 12-week prospective study

Dual- and Triple-Acting Agents for Treating Core and Co-morbid Symptoms of Major Depression: Novel Concepts, New Drugs

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