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May 2008 Off the Wire . . .




Fluoxetine May Help to Curb Disease Activity in Multiple Sclerosis

Article Provided by: Doctor's Guide
Article Date: 6 May 2008
LONDON -- May 6, 2008 -- The selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac) may help to curb disease activity in patients with the relapsing-remitting form of multiple sclerosis (MS). That's the finding of preliminary research published ahead of print in the journal of Neurology Neurosurgery and Psychiatry.

The research team randomly allocated 40 patients with the relapsing-remitting form of MS to treatment with either 20 mg daily of fluoxetine (Prozac) or placebo for 24 weeks. All patients underwent magnetic resonance imaging every 4 weeks to check for new areas of neurological inflammation, a hallmark of active disease. In total, 38 patients -- 19 in each group -- completed the study.

The scans showed that those in the placebo group had more new areas of inflammation compared with those treated with fluoxetine. The effects were evident after 8 weeks, which corresponds to the time that SSRIs start to work on relieving depression. The average number of new areas affected was more than 5 in the group given the placebo compared with just under 2 in the group treated with fluoxetine. One in 4 scans from patients treated with fluoxetine showed new areas of inflammation compared with 4 out of 10 of those taking placebo.

During the last 16 weeks of treatment, almost two-thirds of patients (63%) in the fluoxetine group had no new areas of inflammation compared with only 1 in 4 (26%) in the placebo group.

The authors caution that their study was small and larger studies would be needed before firm conclusions could be drawn. But they conclude that their results are "sufficiently encouraging to justify further studies with fluoxetine in patients with MS," adding that higher doses and treatment combinations with other drugs that alter the immune response should be considered.

SOURCE: British Medical Journal

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