Fluoxetine After Stroke Improves Motor Skills, Independence

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Impaired motor skills due to paralysis and weakness are the most common disabilities after stroke. Results of a new study suggest the antidepressant fluoxetine, when administered early, may improve motor skills in patients who have suffered an ischemic stroke.

Fluoxetine may help stroke patients be independent

Fluoxetine, an antidepressant in the selective serotonin reuptake inhibitor (SSRI) class, was the drug administered in the double-blind, placebo-controlled FLAME (fluoxetine for motor recovery after acute ischaemic stroke) trial. The goal of the trial was to determine whether fluoxetine (Prozac) would boost recovery of motor skills in patients who had suffered ischemic stroke and who had moderate to severe motor deficits.

A total of 118 patients from nine stroke facilities in France were randomly assigned to take fluoxetine (20 mg daily) or placebo for three months starting 5 to 10 days after suffering their stroke. All the patients also participated in physical therapy.

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After 90 days of treatment, patients who took fluoxetine demonstrated significantly greater improvement in motor functioning and were significantly more independent when compared with patients in the placebo group. Motor skill improvements were significant in both the upper and lower limbs. Patients in the fluoxetine group were more likely to experience digestive side effects, such as nausea, diarrhea, and abdominal pain, than those in the placebo group.

Stroke is the third largest cause of death in the United States, and a leading cause of serious, long-term disability, according to the American Heart Association. More than 6.4 million stroke survivors are alive today. The National Stroke Association notes that while a small stroke may result in minor weakness in an arm or leg, individuals who have more serious strokes may be paralyzed on one side or lose their speech. More than two-thirds of stroke survivors have some type of disability.

In another recent study conducted at Beth Israel Deaconess Medical Center, researchers found that stroke patients who were administered electric stimulation, along with physical and occupational therapy, had a threefold better improvement in motor skills when compared with patients who did not receive the stimulation.

Results of this latest study, which appears in Lancet Neurology online, suggest that patients who experience ischemic stroke could benefit from taking fluoxetine within 10 days of the stroke. The significant improvement in motor skills and more independent living suggest fluoxetine is a potential treatment for stroke patients, pending further research.

SOURCES:
American Heart Association
Chollet F et al. Lancet Neurology 2011 Jan 10; DOI: 10.1016/S1474-4422(10)70314-8
National Stroke Association

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