The selective noradrenaline re-uptake inhibitor reboxetine has an early onset of antidepressant action.

Introduction: Most antidepressants take several weeks to demonstrate a therapeutic effect. We examined the time to onset of action of reboxetine, a unique selective noradrenaline re-uptake inhibitor (selective NRI).

Methods: In a multinational, multicentre, double-blind, parallel-group study, 56 inpatients with major depression were randomized to receive placebo or reboxetine titrated to 10 mg/day for 6 weeks. Efficacy was principally assessed by the Hamilton Depression Rating Scale.

Results: Reboxetine was associated with a significantly greater reduction in mean HAM-D total score from baseline to last assessment when compared with placebo. The effect of reboxetine separated from placebo at day 10 (P=0.006), indicated an early onset. In accordance with this observation, individual HAM-D item scores early showed significant improvements among patients treated with reboxetine when compared with those who received placebo: mood improved by day 10 (P=0.004), insomnia and interest in work and daily activities by day 14 (P=0.006 and 0.003, respectively) and somatic symptoms and anxiety by day 21 (P<0.001 in both cases).

Conclusion: Reboxetine is an effective antidepressant with an early onset of action. Depressed mood is relieved first, followed by an improvement in interest in daily activities.