Antidepressants Without United States FDA Approval

Reboxetine is a selective norepinephrine reuptake inhibitor approved for use as an antidepressant in Canada and Europe, but not yet available in the United States. It is a racemic mixture of two stereoisomers, consisting of (S,S)-(+)- and (R, R)-(-)-reboxetine the (S,S) enantiomer is more potent as an antidepressant and has greater affinity to the norepinephrine receptor (213, 214). Women have a 30 higher S, S to R, R ratio than men (215). Reboxetine down-regulates b-adrenergic receptors (213)....

Adverse Effects

The older MAOIs have been limited in use as a consequence of their potential for toxicity. Of greatest concern have been drug-drug interactions with sympathomi-metic amines and the food-drug interaction with tyramine, both of which may cause a hypertensive crisis. Another serious adverse effect is the serotonin syndrome, which can occur when MAOIs are coadministered with SSRIs (83). Other significant side effects include dizziness, hypotension, liver toxicity, dry mouth with GI upset, blurred...

Alternative and Non Traditional Antidepressants St Johns Wort

St John's Wort (Hypericum perforatum, available commercially as Hypericum alcohol extract standardized by level of hypericin) has been used as a traditional herbal medicine for more than 2,000 years. Pharmacologically, the plant contains naphthodianthrones (such as hypericin and pseudohypericin), phloroglucinols (such as hyperforin and adhyperforin), flavonoids, phenylpropanes, proanthocya-nidins, xanthones, and amino acids (357-359). It remains uncertain which of these constituents are...