NRIs are commonly used in the treatment of conditions likeADHD andnarcolepsy due to theirpsychostimulant effects and inobesity due to theirappetite suppressant effects. They are also frequently used asantidepressants for the treatment ofmajor depressive disorder,anxiety andpanic disorder. Additionally, manyaddictive substances such ascocaine andmethylphenidate possess NRI activity, though NRIs without combineddopamine reuptake inhibitor (DRI) properties are not significantly rewarding and hence are considered to have negligible potential for addiction.[1][2] However, norepinephrine has been implicated as acting synergistically with dopamine when actions on the two neurotransmitters are combined (e.g., in the case ofNDRIs) to produce rewarding effects in psychostimulant addictive substances.[3]
A meta analysis published in BMJ in 2011 concluded that the selective NRIreboxetine is indistinguishable from placebo in the treatment of depression.[4] A second review by the European Medicines Agency concluded that reboxetine was significantly more effective than placebo, and that its risk/benefit ratio was positive. The latter review, also examined the efficacy of reboxetine as a function of baseline depression, and concluded that it was effective in severe depression and panic disorder but did not show effects significantly superior to placebo in mild depression.[5]
^Wee S, Woolverton WL (September 2004). "Evaluation of the reinforcing effects of atomoxetine in monkeys: comparison to methylphenidate and desipramine".Drug and Alcohol Dependence.75 (3):271–6.doi:10.1016/j.drugalcdep.2004.03.010.PMID15283948.
