Reboxetine addition in patients with mirtazapine-resistant depression: a case series.
OBJECTIVE
Treatment-resistant depression is a common occurrence in clinical practice as well as combination treatment with 2 different antidepressants. In the present case series, we study the effectiveness of the addition of reboxetine, during 12 weeks, to 14 outpatients diagnosed with major depressive disorder, according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria, who had previously failed to respond or who had only responded partially, over a period of 6 weeks, to conventional treatment with mirtazapine.


METHODS
Evaluation of antidepressant efficacy was carried out through the application of the 21-item Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impressions-Global Improvement Scale (CGI-I).


RESULTS
The percentages of responders (HDRS>or=50%), patients in remission (HDRS<or=10), and improving (CGI-I absolute value<4) were 35.7%, 28.6%, and 64.3%, respectively. No serious side effects were observed during combination therapy, being more frequent dry mouth (2 cases).


CONCLUSIONS
The initial findings of our study show that reboxetine and mirtazapine may constitute an effective and low side effects combination.
López-Muñoz
Francisco
F
Department of Pharmacology, Faculty of Medicine, University of Alcalá, Madrid, Spain. frlopez@juste.net
Rubio
Gabriel
G
Alamo
Cecilio
C
García-García
Pilar
P
Pardo
Antonio
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use*; D000077593:Reboxetine
D000928:Antidepressive Agents; D009025:Morpholines; D008803:Mianserin; D000077593:Reboxetine; D000078785:Mirtazapine