Multiple Sclerosis Activity May Be Affected By Prozac

A new study published in the Journal of
Neurology Neurosurgery and Psychiatry
finds that Prozac, a
commonly prescribed antidepressant, may be an agent in slowing
down the disease process of the relapsing remitting form of multiple
sclerosis (MS).

Multiple sclerosis is an autoimmune disease where the immune system
attacks the central nervous system. In the relapsing remitting form,
new symptoms occur in discrete attacks.

A team of researchers led by J P Mostert (Department of Neurology,
University Medical Center Groningen, University of Groningen,
Groningen, The Netherlands) conducted a double-blind,
placebo-controlled, exploratory analysis of 40 patients
with the relapsing
remitting form of MS. For a period of 24 weeks, half of the sample was
treated with 20 mg daily of fluoxetine
(Prozac) while the other half received a placebo. To measure the
activity of MS, detailed magnetic resonance images (MRI) of the
participants’ brains were completed every four weeks. The researchers
focused on areas of neurological inflammation that would indicate
active disease.

Of the 40 initial patients, 19 participants in each group finished the
study. The main finding was that the patients who were treated with
Prozac had fewer new areas of inflammation than those treated with
placebo. The researchers were able to detect the effects just after
eight weeks – the same amount of time that it takes for selective
serotonin reuptake inhibitor
(SSRI) drugs such as Prozac to begin relieving depression.

Specifically, the group given placebo had an average of over five new
areas affected with inflammation compared to just less than two areas
in the Prozac group. Twenty-five percent of scans from Prozac-treated
patients and forty percent of placebo-treated patients depicted new
areas of inflammation. Almost two out of three patients in the Prozac
group had no new inflammation areas during the last 16 weeks of
treatment, whereas only about 25% of patients in the placebo group had
no new areas.

Although this was a small-scale study and a larger sample size is
required to increase the robustness of results, the authors conclude
that, “Results of our exploratory trial are sufficiently encouraging to
justify further studies with fluoxetine in patients with MS. Higher
doses of fluoxetine and combination treatment with immunomodulatory
drugs should be considered.”

Effects of fluoxetine on disease activity in relapsing
multiple sclerosis: a double-blind, placebo-controlled, exploratory

J P Mostert, F Admiraal-Behloul, J M Hoogduin, J Luyendijk, D J
Heersema, M A van Buchem, J De Keyser
Journal of Neurology
Neurosurgery and Psychiatry
. (2008)
doi: 10.1136/jnnp.2007.139345
Here to See Article Online
(resource no longer available at

Written by: Peter M Crosta

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