Reboxetine Helpful in Obstructive Sleep Apnea Treatment

According to results presented in the Journal of Clinical Sleep Medicine, treatment of obstructive sleep apnea (OSA) with reboxetine (Edronax; Pfizer, New York, NY) was effective at reducing OSA symptom severity. Researchers reported that individuals treated with reboxetine experienced a reduction in the apnea-hypopnea index of 5.4 events per hour (95% CI, -10.4 to -0.3, P=.03) along with a reduction in the 4% oxygen desaturation index of 5.2 ± 7.2 events/hour (mean ± standard deviation). This is the first study to report reboxetine monotherapy as effective in reducing OSA severity. Previous studies have shown improvements in OSA severity with therapy consisting of noradrenergic agents combined with a muscarinic. Reboxetine is a selective noradrenaline reuptake inhibitor indicated for the treatment of major depressive disorder.

This double-blind, placebo-controlled, 3-way crossover study conducted at 2 centers enrolled 16 adult participants with OSA. Participants completed 3 polysomnograms (1-week washout) and were treated with a single dose of 4 mg reboxetine, placebo, or a combination of 4 mg reboxetine and 5 mg oxybutynin (a anticholinergic medication) before sleep. The combination therapy did not result in additional reductions in the apnea-hypopnea index. Results indicated that nadir oxygen saturation levels increased by 7 ± 11% with reboxetine and 5 ± 9% with reboxetine+oxybutynin vs placebo (P=.01). Both reboxetine monotherapy and combination therapy improved pharyngeal collapsibility and respiratory control (loop gain).