In a nutshell
This trial examined the benefits of fluoxetine (Prozac or Fontex) in the motor recovery of patients who suffered a stroke.
Some background
More than half of stroke survivors continue to experience some degree of motor deficit (loss of muscle strength or function due to nerve damage) after a stroke. Hemiplegia (paralysis of the arm and leg on one side of the body) and hemiparesis (weakness on one side of the body) are the most common deficits caused by stroke. Disabilities following a stroke can reduce a patient's ability to perform activities of daily living, and significantly reduce the quality of life.
Serotonin is a neurotransmitter (a molecule used in the body to transmit information between nerve cells) important in the regulation of normal brain and intestinal functions. Fluoxetine belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRI's), which raise serotonin levels in the nervous system. SSRI's are commonly prescribed to treat depression, however, recent trials have suggested that SSRI's may help with motor recovery (recovery of muscle strength and function) in stroke patients.
Methods & findings
113 patients from nine stroke centers in France took part in this study. All patients had suffered an ischemic stroke which resulted in hemiplegia or hemiparesis. Patients were randomly assigned to receive either fluoxetine or a placebo (a substance without any medicinal effect). Patients in both groups received standard physiotherapy in addition to the trial drug. Researchers compared the change in Fugl-Meyer motor scale (FMMS; a scale that represents the improvement in motor function during recovery) scores between patients receiving fluoxetine and those receiving a placebo after 90 days of treatment.
Results showed that fluoxetine significantly improved motor recovery. The average improvement in the FMMS score was 34 points for patients treated with fluoxetine, compared to 24.3 points in patients receiving a placebo.
However, fluoxetine treatment also resulted in an elevated risk for gastrointestinal side effects such as nausea, diarrhea, and abdominal pain.
The bottom line
In conclusion, this trial showed that patients with motor deficits after an ischemic stroke may benefit from fluoxetine treatment in addition to physiotherapy.
The fine print
This trial did not follow up on patient recovery beyond the 90 day trial period. There is no way of determining whether the benefit on motor recovery persisted beyond treatment, and the effect of treatment on long term outcomes.
What’s next?
Consult with your physician regarding the benefits of fluoxetine (Prozac or Fontex) treatment in the recovery of stroke patients.
Published By :
The Lancet neurology
Date :
Feb 01, 2011
