Reboxetine is a 4th generation antidepressant drug . Its mechanism of action involves the selective reuptake of noradrenaline, that is, it is an ISRN (Selective Noradrenaline Reuptake Inhibitor).

In this article we will see what uses this drug has in clinical practice, general characteristics, contraindications, adverse effects and comparison of its efficacy with other antidepressants to treat depression.

Reboxetine: general characteristics

Reboxetine is an antidepressant drug, specifically an ISRN (Selective Noradrenaline Reuptake Inhibitor). What it does, by blocking the reuptake of noradrenaline, is to increase the concentration of noradrenaline in the synaptic space (and thus in the brain), as this substance has been found to be greatly diminished in depressed patients, as have serotonin and dopamine.

It is considered a 4th generation antidepressant (the first ISRN), highly selective and very powerful. It was approved in many European countries in the late 1990s as a treatment for depression.

Furthermore, has a weak effect on serotonin (5-HT) reuptake and does not affect dopamine uptake . It is generally used as an adjunct to SSRIs (Selective Serotonin Reuptake Inhibitors).

Indications and contraindications

Regarding its indications, reboxetine is indicated for the acute treatment of major depressive disorders (and other depressive disorders) and for the maintenance of clinical improvement in patients who have responded to treatment initially. With regard to depression, it is specifically effective for moderate to severe depressive disorders, as well as for dysthymic disorder (dysthymia).

It is also indicated for the long-term treatment of children with ADHD (Attention Deficit Hyperactivity Disorder) who have had a poor response or poor tolerance to initial treatment with methylphenidate (a psychostimulant). Finally, it is also indicated in some cases of panic disorder.

On the other hand, it is contraindicated in patients with hypersensitivity to reboxetine itself (i.e. to its active ingredient or to any of its excipients). On the other hand, reboxetine is not recommended in elderly patients, nor in children or adolescents under 18 years of age .


Trade names

Re-boxetine is marketed in medicines under different trade names: Davedax, Edronax, Norebox and Solvex .


4th generation antidepressants

As we have seen, reboxetine is considered a 4th generation antidepressant, along with other SNRIs and alongside dual antidepressants, i.e. drugs that inhibit the reuptake of both serotonin and noradrenaline (SNRIs).

Examples of dual antidepressants are venlafaxine (treatment of choice for Generalized Anxiety Disorder [GAD]) and duloxetine. In addition, an advantage of duals is that they don’t affect adrenaline or histamine, producing fewer side effects than other types of antidepressants.

Side effects

The main side effects that reboxetine can produce are abdominal pain, headaches and decreased appetite (are the most frequent). Others may also appear such as nausea, vomiting, constipation, dry mouth and drowsiness.

Other effects that may appear, although very rare (affecting 1/10 of every 1,000 patients) are dilated pupils and the sensation of spinning (vertigo).

In the case of children, even if reboxetine is well tolerated (demonstrated in clinical studies), adverse effects such as dizziness, dry mouth, anorexia and insomnia may occur.


On the other hand, some antidepressants such as reboxetine have produced seizures in clinical trials , so great caution should also be exercised in the case of patients with a history of seizure disorders. Drug treatment should be discontinued if the person develops seizures at any time.

Finally, precautions should also be taken in the case of patients with bipolar disorder, heart disorders, glaucoma or urinary retention .

Pregnancy and lactation

It is not known exactly what effects reboxetine may have during pregnancy; therefore its use is not recommended if you are pregnant, unless your doctor considers it absolutely necessary and after a clinical risk/benefit analysis.

As for breastfeeding, reboxetine is found in breast milk (in small amounts), so there is a risk of producing an effect on the baby. You should always consult a doctor if you are breastfeeding.

Suicide risk

In the initial treatment with antidepressants, it has been seen how some of them can produce suicidal ideation ; this can also occur with reboxetine.

Patients most at risk are those with a previous history of suicide-related events or a significant degree of suicidal ideation prior to the start of treatment. This is why these patients should be closely monitored during treatment.

This is because the therapeutic effects of antidepressant drugs take time to appear once treatment has begun (usually 2 weeks or more). Adverse effects, on the other hand, appear immediately .

Comparison with other psychopharmaceuticals

In comparison with tricyclic antidepressants, reboxetine has been shown to be just as effective as tricyclic antidepressants for major depression, and more effective than fluoxetine (a type of SSRI) for depressive symptoms related to social functioning (such as abulia).

Bibliographic references:

  • Arabgol, F., Panaghi, L. and Hebrani, P. (2009). Reboxetine versus methylphenidate in the treatment of children and adolescents with attention deficit-hyperactivity disorder. Eur Child Adolescent Psychiatry, 18(1): 53-9.
  • Pediamécum. (2015). Reboxetine.
  • Stahl, S.M. (2002). Essential Psychopharmacology. Neuroscientific bases and clinical applications. Barcelona: Ariel.
  • Vademecum. (2015). Reboxetine.