Reboxetine for ADHD
Reboxetine
- inhibits the noradrenaline transporter
- inhibits the dopamine transporter
- weakly inhibits the serotonin transporter
Trade names: Edronax (D, CH, A), Solcenx (D)
The active ingredient reboxetine is a primarily noradrenergic drug which, according to individual reports, can be effective for ADHD. As an antidepressant, as it was actually intended to be, it was probably quite unsuccessful.
Approval only in the EU, not in the USA.12
The Effect size on depression is worse than that of other antidepressants with relatively high side effects.3
As a noradrenaline reuptake inhibitor, reboxetine inhibits the noradrenaline transporter. In the PFC (but not in other brain regions), the NET also reuptakes dopamine, even a little more than noradrenaline. Therefore, selective noradrenaline reuptake inhibitors have a dopaminergic and noradrenergic effect in the PFC, but a noradrenergic effect in other brain regions.
Reboxetine also slightly inhibits the dopamine transporter and the serotonin transporter.
The updated European consensus on the diagnosis and treatment of ADHD (2018) names reboxetine as a possible alternative to atomoxetine for ADHD.4
There is evidence that reboxetine is effective for ADHD. However, there are only a few controlled studies. Reboxetine could be used primarily in adults without comorbidities.56
One study found a positive effect on ADHD and on anxiety symptoms in children and adolescents with ADHD and comorbid anxiety disorder.7
Other studies also found an improvement in ADHD symptoms in children and adolescents with low side effects.891011
Reboxetine is not reimbursed by health insurance companies in Germany.
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Ghanizadeh (2015): A systematic review of reboxetine for treating patients with attention deficit hyperactivity disorder. Nord J Psychiatry. 2015 May;69(4):241-8. doi: 10.3109/08039488.2014.972975. PMID: 25415763. REVIEW ↥
Riahi, Tehrani-Doost, Shahrivar, Alaghband-Rad (2010): Efficacy of reboxetine in adults with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled clinical trial. Hum Psychopharmacol. 2010 Nov;25(7-8):570-6. doi: 10.1002/hup.1158. ↥
Riahi F, Tashakori A, Izadi-Mazidi S, Salehi-Veysi M (2013): Effectiveness of reboxetine in treatment of outpatient children and adolescents with attention deficit-hyperactivity disorder with comorbid anxiety disorders. Iran J Psychiatry. 2013 Oct;8(4):195-200. PMID: 25628714; PMCID: PMC4281655. n = 25 ↥
Ratner S, Laor N, Bronstein Y, Weizman A, Toren P (2005): Six-week open-label reboxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2005 May;44(5):428-33. doi: 10.1097/01.chi.0000155327.30017.8c. PMID: 15843764. n = 31 ↥
Cohen-Yavin I, Yoran-Hegesh R, Strous RD, Kotler M, Weizman A, Spivak B (2009): Efficacy of reboxetine in the treatment of attention-deficit/hyperactivity disorder in boys with intolerance to methylphenidate: an open-label, 8-week, methylphenidate-controlled trial. Clin Neuropharmacol. 2009 Jul-Aug;32(4):179-82. doi: 10.1097/WNF.0b013e318183796d. PMID: 19644227. n = 27 ↥
Tehrani-Doost M, Moallemi S, Shahrivar Z (2008): An open-label trial of reboxetine in children and adolescents with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2008 Apr;18(2):179-84. doi: 10.1089/cap.2006.0034. PMID: 18439114. n = 20 ↥
Toren P, Ratner S, Weizman A, Lask M, Ben-Amitay G, Laor N (2007): Reboxetine maintenance treatment in children with attention-deficit/hyperactivity disorder: a long-term follow-up study. J Child Adolesc Psychopharmacol. 2007 Dec;17(6):803-12. doi: 10.1089/cap.2006.0145. PMID: 18315452. n = 6 ↥