title: Pharmacokinetics of reboxetine in elderly patients with depressive disorders.
abstract: OBJECTIVE
  To examine the pharmacokinetic characteristics of the selective norepinephrine reuptake inhibitor, reboxetine, in elderly patients with depression.
  
  
  METHODS
  Twelve female inpatients (mean age 80 +/- 4 years) with major depressive or dysthymic disorder were enrolled in a 4-week uncontrolled study of oral reboxetine 2-8 mg/day.
  
  
  METHODS
  After a one-week washout period, patients were randomized into two groups (groups A and B, n = 6/group). Reboxetine was given twice daily, starting with 2 mg/day during week 1 and increasing by 2 mg/day each week to 8 mg/day in week 4. Pharmacokinetic evaluations were carried out at two dosage levels in each group: at the end of weeks 1 and 3 in group A (2 and 6 mg/day), and at the end of weeks 2 and 4 in group B (4 and 8 mg/day). Blood and urine samples were taken for determination of reboxetine pharmacokinetics.
  
  
  RESULTS
  Reboxetine displayed linear pharmacokinetics, with dose-proportional changes, in elderly depressed patients. Mean total urinary recovery ranged from 4.06 to 6.17%. The mean area under the plasma concentration-time curve (AUCtau) and the maximum plasma drug concentration (Cmax) showed considerable variation between patients; at a dosage of 4 mg/day, AUCtau was 1,466-6,866 ngxh/ml and Cmax ranged from 169 to 663 ng/ml.
  
  
  CONCLUSIONS
  The pharmacokinetics of reboxetine are linear across the dosage range of 2-8 mg/day in elderly depressed patients, although Cmax and AUCtau values are higher (and more variable) than in young adults. These results support the use of a lower starting dose (4 mg/day) of reboxetine in the elderly.
authors.affiliation: Pharmacokinetics and Metabolism Department, Pharmacia and Upjohn S.p.A., Milano, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Poggesi
authors.forename: C
authors.initials: C
authors.lastname: Pellizzoni
authors.forename: J C
authors.initials: JC
authors.lastname: Fleishaker
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003866:Depressive Disorder / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D009025:Morpholines / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000077593:Reboxetine
chemical_list: D018759:Adrenergic Uptake Inhibitors; D009025:Morpholines; D000077593:Reboxetine