Talk:Reboxetine

The claim that reboxetine is known to induce a massive mania in patients with bipolar disorder

As I can't find a good reference to support the unsourced claim that reboxetine is known to induce a massive mania in patients with bipolar disorder, and because it seems that it's not only doubtful, but could also be somewhat harmful, I removed it pursuant with Wikipedia:Citing_sources#Unsourced_material.

--julian 13:38, 20 June 2007 (UTC)

Therapeutic index

Hi,

my package insert claims that reboxetine has a low therapeutic index. I'm confused, because from what I've read online, it is quite safe. Anyone please clarify? (I know WP is not a forum, but this would be a reasonable addition to the article too ;))

Reboxetine in combination with SSRIs

The article suggests that it is safe to combine reboxetine with an SSRI because it doesn't inhibit the reuptake of serotonin. Whilst this is true and there isn't a risk of serotonin syndrome, there is still a potential for an interaction with many SSRIs, as the article later goes on to say: "According to Weiss et al, reboxetine is an intermediate-level inhibitor of P-glycoprotein, which gives it the potential to interact with ciclosporin, tacrolimus, paroxetine, sertraline, quinidine, fluoxetine, fluvoxamine." The external link given at the bottom of the article ([1]) also suggests that it should be avoided. This is, in effect, a contradiction in the article. Orientalmoons (talk) 16:50, 23 March 2008 (UTC)

Is there any empirical evidence of actual problems due to this? I am not a doctor, but to my knowledge you won't exactly die from slightly increased SSRI levels. Suboptimal Username (talk) 04:25, 24 March 2008 (UTC)

A citation is required if the article is to specifically state that it is safe - if not, guesswork is not acceptable and this paragraph should be removed. The manufacturer's product characteristics says "Concomitant use of reboxetine with other antidepressants (tricyclics, MAO inhibitors, SSRIs and lithium) has not been evaluated during clinical trials.". --Davidcx (talk) 18:59, 2 June 2010 (UTC)

I have removed the offending claim until such time as it can be substantiated. --Davidcx (talk) 21:00, 14 June 2010 (UTC)

Studies controversy

http://de.news.yahoo.com/12/20090610/thl-iqwig-pharma-unternehmen-halten-arzn-d343981.html [in German] Pfizer apparently withholds key data of 9 scientific studies regarding Edronax. Dysmorodrepanis (talk) 19:09, 10 June 2009 (UTC)

BMJ published article regarding efficacy of Reboxetine

"Conclusions Reboxetine is, overall, an ineffective and potentially harmful antidepressant. Published evidence is affected by publication bias, underlining the urgent need for mandatory publication of trial data." http://www.bmj.com/content/341/bmj.c4737 87.114.222.228 (talk) 23:00, 18 October 2010 (UTC)

That article is only focusing on "acute treatment of major depression". What about the off-lable use for treating ADHD? 93.199.76.8 (talk) 11:52, 11 January 2011 (UTC)

Chemistry

Shouldn't be the title "Synthesis" and is the synthesis shown the one used for the large scale synthesis of the approved drug or just a lab synthesis? It is the latter case the I don't think it is noteworthy since there are for sure a lot of other small scale synthesis published in the chemical literature. Panoramix303 (talk) 13:35, 22 January 2011 (UTC)

See also

Hi Aurochs, can you say why you keep removing the See also to Bad Pharma? This is one of the drugs Goldacre discusses as illustrative of the problems caused by unpublished data. SlimVirgin ^(talk) 23:23, 20 October 2012 (UTC)

Okay, I see you prefer to use it as a source. I'll add page numbers. SlimVirgin ^(talk) 23:28, 20 October 2012 (UTC)

My concern was that the book as a whole is about the corrupt practices of the pharmaceutical industry, and the reboxetine controversy is just one example of just one of the problems Goldacre discusses. In other words, I don't think the book is specific enough to include as a further reading link, especially when it's the only further reading link in the article. If you prefer to have something more obvious, I don't have any problems with including the link at the top of the efficacy section as a see also thingie.

Unrelated, but WP needs a better discussion about the pharmaceutical industry's scientific ethics. There are other authors who have been writing about the same thing for years (Daniel Carlat comes to mind), so it's not like there's not enough material. --Aurochs (Talk | Block) 23:52, 20 October 2012 (UTC)

I was thinking of starting a template about pharmaceutical industry ethics (listing the authors, books, incidents), but I haven't collected the articles yet to see whether it would be viable. Still trying to finish writing Bad Pharma. I may take you up on the suggestion of adding it as a See also link in the efficacy section. SlimVirgin ^(talk) 00:20, 21 October 2012 (UTC)

Why did you make the book ref a bullet point inside another ref? That seems unusual. --Aurochs (Talk | Block) 00:45, 22 October 2012 (UTC)

• I did that to prevent having two footnotes listed in a row (see WP:CITEBUNDLE). But if you prefer it that way, I don't mind if you change it. SlimVirgin ^(talk) 00:48, 22 October 2012 (UTC)

I've never seen that done before, and I've been here for six years. I guess I haven't been reading the right articles. It looks fine as long as the book isn't supporting anything that the article it's bundled with doesn't (which I don't anticipate in this article). --Aurochs (Talk | Block) 01:16, 22 October 2012 (UTC)

In the U.S., where reboxetine isn't approved, it's more notable as an example of selective publication of data than it is as an NRI. In fact, I think that's true in Europe too. Wikipedia isn't a collection of package inserts. If there's a social or economic context to a drug, we should include that in the article too. --Nbauman (talk) 07:58, 23 September 2013 (UTC)

ADHD

It baffles me that this drug was ever studied as an antidepressant instead of an ADHD medication, since it's the same family as medications used for ADHD (Norepinephrine reuptake inhibitors), a fact that I think might be important to mention. A quick google search also revealed a couple of studies that have been done in that area:

• http://www.ncbi.nlm.nih.gov/pubmed/21312292
• http://www.ncbi.nlm.nih.gov/pubmed/19644227
• http://www.ncbi.nlm.nih.gov/pubmed/15843764
• http://www.ncbi.nlm.nih.gov/pubmed/18439114
• http://www.ncbi.nlm.nih.gov/pubmed/18315452

Just leaving this here until I or somebody else has the time/patience to edit the page, change the text and include these. — Preceding unsigned comment added by 85.244.51.146 (talk) 17:07, 2 November 2012 (UTC)

As far as being studied for depression, desipramine is a selective NRI used for treating MDD, so that's not exactly a left-fielder. You'll note that atomoxetine (Strattera) was also originally studied for depression, and only later did it become apparent that it was useful for treating ADHD.
All of those articles are primary research. Secondary research is preferred for our purposes. See WP:PRIMARY. I don't think it would be all that difficult to find a review article covering reboxetine's potential use as an ADHD medication. --Aurochs (Talk | Block) 04:35, 3 November 2012 (UTC)

Rework

Reboxetine.com is insufficient for the purposes of this article. This is a reminder to remove and/or edit this information. The efficacy section is largely a paraphrase of the Reboxetine subsection of Stahl's Psychopharmacology. Jdoelder (talk) 03:14, 3 July 2013 (UTC)

Trials Published

4 trials took place comparing it to other antidepressants, only 1 that showed it to be as effective, the other 3 showed it to be less effective (evidence from registry of approved drug trials) were not published. www.alltrials.net — Preceding unsigned comment added by 81.99.74.135 (talk) 18:29, 7 January 2017 (UTC)

Venlafaxine content

User: 2a00:23c5:628c:a000:e8ec:611a:6d4d:865 --

about this addition of an unsourced observation: Venlafaxine has a similar selectivity ratio in the opposite direction, but is classed as an SNRI.

followed by this: Venlafaxine has a similar selectivity ratio in the opposite direction, but is classed as an SNRI.

followed by this:

Venlafaxine has a similar selectivity ratio in the opposite direction, but is classed as an SNRI.

References

The first time it was unsourced; the second time, a ~20 year old primary source was provide, the third time, a 7 year old primary source was provided, that says nothing about the selectivity of Venlafaxine and doesn't mention reboxetine at all. I have been looking for a reliable source to be cited here, to see if the source says anything about why this is relevant in this article. IP, are you making some comment on the breadth of the term SNRI or something? If so that probably belongs in the SNRI article and would need to be discussed in the source. As it stands it appears you are just making a personal observation, and that is not OK here. But perhaps I am missing something. Please explain why this content is relevant here in your view. thx Jytdog (talk) 20:53, 17 June 2017 (UTC)

The third source does show the selectivity ratio of venlafaxine (535 for NET and 27 for SERT) in one of the diagrams, but yes I suppose the point was to comment on the breadth of the term SNRI. Point being, if reboxetine does have a clinical effect on serotonin at higher doses (as venlafaxine has a clinical effect on NE at higher doses), and they have similar selectivity ratios in the opposite direction, a sentence outlining that fact I thought may have been relevant. For instance, in the article on Atomoxetine a similar point is made in the pharmacology section ("Assuming that these findings translate to humans, atomoxetine would in fact be a serotonin-norepinephrine reuptake inhibitor (SNRI) rather than a selective NRI as has conventionally been assumed") 2A00:23C5:628C:A000:64C9:93EC:12FA:A44F (talk) 21:58, 17 June 2017 (UTC)

Thanks for pointing out the other article - that too was OR and was directly contradicted by the source cited. I fixed it this diff. Jytdog (talk) 04:50, 18 June 2017 (UTC)