Depressive reaction to moxonidine (CYNT, generics): A 71-year old man took 0.2 mg moxonidine (CYNT, generics) daily for elevated blood pressure. After doubling the dose he suffered from lack of drive, compulsive brooding and suicidal thoughts. This condition lasted for months but improved within two days after discontinuing moxonidine (NETZWERK report 14.697). A few months after moxonidine was first marketed in autumn 1991 we received two reports of depression in association with the antihypertensive agent (5.566, 5.691, see a-t 1993, No. 1: 20). Moxonidine is similar to the alpha-2 adrenergic agonist clonidine (CATAPRESAN, generics), which often produces depressive moods (Boehringer Ingelheim: CATAPRESAN prescribing information, May 2005). Anxiety and depression are listed as occurring uncommonly in the prescribing information, for example, of MOXONIDIN HEXAL or MOXONIDIN RATIOPHARM (Sept. and Aug. 2003 respectively), but not in that of CYNT or PHYSIOTENS (Lilly: CYNT SPC, Nov. 2006; Solvay: PHYSIOTENS SPC, Aug. 2006). To our enquiry regarding this discrepancy, the two original suppliers respond in the same words, that there is "no evidence that alterations in mood state are causally associated with moxonidine"; the "procedure" had been followed "in agreement with the BfArM [Federal Institute for Drugs and Medical Devices]" (Lilly and Solvay: letter of 1 Apr. 2008). While the Red List specifies 38 possible side effects for MOXOBETA, it lists only 16 for CYNT, which contains the identical drug (http://www.rote-liste.de). It is reasonable to doubt whether healthcare professionals can obtain reliable information about drugs to be prescribed using product information (SPCs) and the Red List. We regard moxonidine, the clinical benefit of which is not proven, as dispensable. -ed.