Multiple Sclerosis Activity May Be Affected By Prozac

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Main Category: Multiple Sclerosis
Also Included In: Depression;  Clinical Trials / Drug Trials;  MRI / PET / Ultrasound
Article Date: 03 May 2008 - 0:00 PST

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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 study
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
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Written by: Peter M Crosta



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