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What was the deal with the Reboxetine clinical trials?

JohnBoy2000

JohnBoy2000

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Joined
May 11, 2016
Messages
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Cause I'm looking for a noradrenergic based drug that doesn't induce sedation - and reboxetine would be perfect - only, there's all this hubbub about the manufacturers having "buried" a plethora of negative clinical trial data.

That being said, reboxetine is marketed in a hell of a lot of countries, and there is still much clinical data that speaks favorably of it.

My own personally devised and almost certainly, wildly inaccurate hypothesis is - for the majority of people, noradrenergic dysfunction, which is associated more so with chronic fatigue, irritable bowel, cognitive impairment - but less so with actual low mood and depressed feelings - does not play a part.
Therefore, in meta-analysis clinical trials over huge numbers of people, reboxetine comes up short.

But small scale trials with non-responders to SSRI's (serotonin not being the implicated receptor), reboxetine seems to do very well indeed.

Maybe that's wishful thinking - as I'm an SSRI non-responder - but intuitively, on some level, it makes sense.

I don't think it's a positive approach to bracket all anti-depressants as either "effective or non-effecitive" on such a large scale, as different neurotransmitters are implicated for different people and - I think serotonin leads the charge in that sense as the majority of people tend to get, "sad" - not, crippled with weakness and lethargy, but remain relatively upbeat.


But anyways - ultimately, the point being - Reboxetine.
A potentially effective AD - or a fraud?

Discuss.
 
U might be intrestes in on youtu ve saplosky depression. He is a professor and goes into the many theories of the biology of depression uve probably never heard of him but im sure his ideas you have he showed that changes in stress in apes can influence its hormone levels in the blood and differences in brains of high up and low class monkeys
 
Cotcha Yankinov said:
https://www.ncbi.nlm.nih.gov/m/pubmed/20940209/

I suppose there is still a chance that Reboxetine is effective for some subtype(s) of depression, or another neuropsychiatric condition that can be misdiagnosed as depression.
Click to expand...

That's what I mean - those meta-analysis trials.
They seem so watered down.

Maybe I'm trying to look at the positives here but,

https://www.ncbi.nlm.nih.gov/pubmed/12920412

Another neuropsychiatric condition mistaken for depression?
Can you give an example of one that may occur?
 
It all depends on what you want to count as statistically meaningful improvement as well. What has been generally found is that anti-depressants work best in the category of severely depressed patients, and they don't work as well for mild/moderate depression.

https://www.ncbi.nlm.nih.gov/pubmed/12172339
"A significantly greater proportion of patients treated with either reboxetine or fluoxetine also achieved a response (>or=50% reduction in HAM-D) or remission (HAM-D <or=10 points) than those who received placebo (p < 0.01 for both analyses).

Similar findings were recorded in a subpopulation of severely ill patients, with statistically significantly greater decreases in the mean HAM-D total score between both active treatment groups compared with placebo (p < 0.024)."


RE similar neuropsychiatric conditions, for example Autism Spectrum Disorder patients often have co-morbid depression and OCD. But it seems there is some debate about how to diagnose what. So for example, do we consider it primary ASD and then secondary depression, such so that when we do studies we can say "ASD patients with depression responded better to xyz", or "ADHD patients with depression responded better to xyz".

My first guess would be that ADD/ADHD patients would tend to benefit more from an NRI because its a medication used to treat ADHD as well (increases DA/NE in the PFC).

So a theoretical example would be that maybe its the ADD/ADHD subgroup of patients in the reboxetine trials that benefit, but their sole improvement doesn't lead to enough statistical significance to declare reboxetine effective.
 
I don't really see how a pure adrenergic would do much to improve depression (especially if it's accompanied by anxiety), but I guess everyone's different, so who knows?
 
I had suicidal depression with psychomotor retardation. Meaning while sober if you saidbwhat daybis it . It slowly say
To....
Day?....
Is......
Uhhhhjjj
I
Dont.........
Kmow


A also i had severe defecits in grooming, focus, energy, motivation, memory.


Noradrenaline may play a role in both increasing grooming and increasing focus and cognitive deficits od severe depression.


Care must be takennthough because it also plays a role in the stress responses and that can make some depressed invidual more suicidal


If it is like strattera it may also block nmda and potassium ion chaneels
 
Ozle said:
I don't really see how a pure adrenergic would do much to improve depression (especially if it's accompanied by anxiety), but I guess everyone's different, so who knows?
Click to expand...

What's your logic behind that?
 
hi, very very important to ask please, does reboxetine have any vasoconstrictive action??? anyone with experience, please!
 
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