Combination therapy with reboxetine for major depression patients who are partial or nonresponders to serotonin selective reuptake inhibitors

Abstract

Introduction. Recent studies have confirmed the usefulness of the therapeutical combination of two antidepressants from different pharmacological families in patients with single drug therapy resistant depression.

Methods. In this prospective 6 weeks open-labeled study, efficacy of combination strategy was evaluated. This included the addition of reboxetine to 34 outpatients with DSM-IV major depressive disorder, who had not responded previously, or who partially responded to conventional treatment in single drug therapy with serotonin selective reuptake inhibitors (SSRI). Data were analyzed on a intent-to-treat basis.

Results. Mean decrease in the 21 item Hamilton depression rating scale (HDRS) score was 49.4% (from 26.9 to 13.6; p<0.0001) and in the clinical global impressions scale (CGI) was 40.4% (from 4.6 to 2.7; p<0.0001). At the end of the treatment, 47.1% of the patients we re considered in remission (HDRS 10), 55.9% evaluated as responders (HDRS 50%) and 58.8% considered as having improvement (CGI<4). No serious side effects we reobserved during combination therapy, the most frequent being n e rvousness and the urinary hesitancy (5.9% ).

Conclusions . The results of this study suggest that addition of reboxetine to SSRI may be an effective and well-tolerated strategy in treatment-resistant patients who have failed to adequately respond to single drug therapy with SSRI.