Tests Find Rival to Prozac

ABCNEWS

(Reuters) V I E N N A,   Austria,   Sept. 16 — A new drug has outperformed Eli Lilly 's best-selling Prozac in treating depression and getting patients back into everyday life faster, experts said on Tuesday.
     Professor of psychiatry Stuart Montgomery of Imperial College, London, said that studies on Edronax (reboxetine), produced by Swedish-U.S. drugs group Pharmacia & Upjohn Inc., had shown remarkable results.
     "In a direct head-to-head comparison Edronax is significantly better in treating severe depression than Prozac," he said, summarizing a report presented at a European College of Neuropsychopharmacology forum in Vienna.

Jump Starting a Social Life
Montgomery said that the trials also included a scale measuring patients' ability to be rehabilitated in society.
     "Edronax showed a similar efficacy but it seemed to be significantly faster than Prozac in making people start participating socially again," he said.
     Depression—mood and anxiety disorder—is estimated to cost the United States alone over $53 billion a year, mainly through absenteeism among workers and reduced productivity.
     The 1996 World Health Organization report forecast that depression will be the leading cause of disability in the developing world by 2020. Currently 10 percent of the developed world suffers from depression.
     Edronax was launched in Britain in July and is awaiting approval in the rest of Europe.
     Depression is believed to be caused by an imbalance in the brain's noradrenergic and serotonergic neurotransmitters.

Noradrenalin Not Serotonin
Edronax is unique because it acts purely on the noradrenalin reuptake inhibitor, having no effect at all on the serotonin transmitter.
     Antidepressants come in three main classes—tricyclics, selective serotonin reuptake inhibitors (SSRIs) which just act on the serotonin transmitter, and dual-action noradrenergic and specific serotonergic antidepressants (NaSSAs).
     Experts believe drive and motivation are related to noradrenalin, whereas mood states are associated with serotonin. Edronax has been found to have a direct and fast-working impact on patient motivation and drive.
     "We now realize that some aspects of SSRIs don't check all the symptoms and there is a need for improvement. That's where Edronax is different as social phobias seem to respond very well early on," said Brian Leonard, psychiatry professor at University College, Gallway.

Sex: Yes, Sedation: No
Leonard also said Edronax had no sedative qualities and did not produce the major adverse side effects shown with tricyclics such as sexual dysfunction, which often cause patients to discontinue treatment.
     "The drug is well-tolerated and should theoretically get people out of hospital and back to work faster and reduce the damage of depression faster," Montgomery said.
     "There is good evidence from placebo-controlled trials of acute efficacy and in long term treatment the drug certainly works in depression, and particularly in the severe depression group, which is difficult to treat," he added.
     Montgomery said trials showed that the number of suicide attempts by patients had been slightly lower than with patients on placebos and SSRIs and significantly below the number of attempts by patients taking tricyclics.
     "This (drug) is a very important step because it helps to delineate both how depression is working and aspects of social function. It's a very exciting development," Montgomery said

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