Montgomery S A
Imperial College of Medicine at St Mary's, London, UK.
J Clin Psychiatry. 1998;59 Suppl 14:26-9.
A comprehensive series of clinical trials have compared the unique selective NRI reboxetine with placebo and with the TCAs imipramine and desipramine, as well as with the SSRI fluoxetine. Reboxetine is clearly effective in both the short and the long term compared with placebo. Against comparator antidepressants, reboxetine is at least as effective in the treatment of patients with major depressive disorder in the adult and the elderly population and offers a significant advantage over imipramine in the treatment of melancholic patients. In severely depressed patients, reboxetine was significantly more effective than fluoxetine. Reboxetine also offers significant advantages over fluoxetine in terms of social functioning and has a significantly improved adverse event profile compared with TCAs. In comparison with fluoxetine, reboxetine has a different adverse event profile, but shows advantages in terms of agitation/nervousness/anxiety and gastrointestinal events. Reboxetine is not cardiotoxic, and it is not associated with an increased risk of seizures or of orthostatic hypotension. Overall, reboxetine offers a significant safety advantage over TCAs in the treatment of the depressed population and in subsets of the depressed population in an efficacy comparison with the SSRI fluoxetine.
一系列全面的临床试验将独特的选择性去甲肾上腺素再摄取抑制剂瑞波西汀与安慰剂、三环类抗抑郁药丙咪嗪和地昔帕明以及与选择性5-羟色胺再摄取抑制剂氟西汀进行了比较。与安慰剂相比，瑞波西汀在短期和长期均明显有效。与对照抗抑郁药相比，瑞波西汀在治疗成人和老年重度抑郁症患者方面至少同样有效，且在治疗抑郁性患者方面比丙咪嗪具有显著优势。在重度抑郁症患者中，瑞波西汀比氟西汀明显更有效。瑞波西汀在社会功能方面也比氟西汀具有显著优势，并且与三环类抗抑郁药相比，其不良事件谱有显著改善。与氟西汀相比，瑞波西汀有不同的不良事件谱，但在激动/紧张/焦虑和胃肠道事件方面显示出优势。瑞波西汀无心脏毒性，也不增加癫痫发作或体位性低血压的风险。总体而言，在治疗抑郁症患者以及在与选择性5-羟色胺再摄取抑制剂氟西汀进行疗效比较的抑郁症患者亚组中，瑞波西汀比三环类抗抑郁药具有显著的安全性优势。
