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Reboxetine
General information
Reboxetine is a selective noradrenaline re-uptake inhibitor with low affinity for α-adrenoceptors and muscarinic receptors [ ].
In controlled trials the following adverse events occurred significantly more often with reboxetine than with placebo: dry mouth (27%), constipation (17%), increased sweating (14%), insomnia (14%), urinary hesitancy (5%), impotence (5%), tachycardia (5%), and vertigo (2%) [ ].
Organs and systems
Endocrine
Pseudopheochromocytoma has been attributed to reboxetine [ ].
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A 47-year-old man, who was taking colchicine for familial Mediterranean fever, developed major depression and was given reboxetine 8 mg/day, fluoxetine 20 mg/day, and clonazepam 2 mg/day. After 1 year, he developed episodic dizziness and syncope with asymptomatic runs of sinus tachycardia (118/minute) lasting up to 4 minute. He was given metoprolol 50 mg/day but continued to have symptoms. His lying blood pressure was 148/85 mmHg, with a marked fall to 100/50 on standing, when his heart rate rose from 84 to 114/minute. Pheochromocytoma was suspected, and urinary collections for catecholamines and their metabolites showed very high concentrations. Reboxetine and fluoxetine were withdrawn and the urinary catecholamines and metabolites became normal. He was free of symptoms 2 years later.
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