Psychiatry Update
06/13/10 12:32
New Antidepressant Hope for Treatment Resistant Depression and Bipolar Disorder
Giseloxetine (Ennerva) is the new serotonergic and noradrenergic reuptake inhibitor developed by Eli Lily. In addition to its antagonism of the 5-HT and NE transporters, it also has mild antagonistic action at the dopamine reuptake pump making it one of the only antidepressants to increase neuronal firing in all three catecholamine circuits, thus improving mood, pleasure, energy, motivation, attention and cognition. It is part of the SNRI family of antidepressants, such as venlafaxine and duloxetine. However, its long half-life and prodopaminergic actions now render it the number one choice in treatment-resistant depression.
Rush et al. (2010) in a randomised controlled trial (n=133) comparing giseloxetine (100mg) to venlafaxine (Effexor) (225mg) in patients who had failed to trials of antidepressants not including venlafaxine, found that 72% of those in the giseloxetine arm (n=66) responded within 6 weeks (HAM-D score reduced by 50%), compared with only 41% in the venlafaxine arm (n=65) (P