What is it?

Fluoxetine is better known by its brand name, Prozac, and it is commonly linked to its primary indication, depression. However, a recent study in a small group of patients has shown that fluoxetine may be used to help stroke survivors recover motor skills after an ischemic stroke. Long-term use of the drug after moderate to severe ischemic stroke has shown promise in restoring the patient’s ability to walk and use the hands. It is also known by the names Rapiflux, Sarafem, Selfemra, and PROzac Pulvules.

How does it work?

Fluoxetine works by increasing the amount of the neurotransmitter serotonin in the synapses between brain cells. Serotonin is important in mood regulation and producing good feelings. By increasing the amount of serotonin in the brain, it influences mood. Research has shown that it can also affect other parts of the brain which make it important in stroke recovery. It increases the plasticity of the brain, or the brain’s ability to learn, and it excites the motor cortex. Through these two functions, fluoxetine is thought to help stroke victims overcome motor deficits and paralysis.

What is it used for?

This medication is primarily used for the treatment of mood disorders. It was designed for use in depression, but it has also been used as a treatment for bipolar disorder, anxiety, anorexia, post-traumatic stress disorder, and seasonal affective disorder. It has also found some usage in alcoholism, premenstrual dysmorphic disorder, and obsessive compulsive disorder.

Research and Evidence

In an earlier study published by Clinical Neuropharmacology in 2009, stroke victims who suffered chronic motor dysfunction were given fluoxetine. The authors found that these patients were able to recover some of their motor function when compared to a placebo group.

In a subsequent study published in Lancet Neurology in 2011, a small group of stroke patients were recruited to receive either fluoxetine of placebo. The investigators found that early and long term use of fluoxetine appears to improve motor recovery in stroke victims as compared to placebo. Each group was evaluated for three months, and they both received the same physical therapy care. With such encouraging results, more research needs to be conducted to determine how effective it is in a large scale study.

 

References

Future Medicine; Long-term administration of fluoxetine to improve motor recovery after stroke;
Hanneke I Berends, et. al.; 2011

http://www.futuremedicine.com/doi/pdf/10.2217/fnl.11.28

Clinical Neuropharmacology; Single Dose of Fluoxetine Increases Muscle Activation in Chronic Stroke Patients; Hanneke Irene Berends MSc, et. al.; January 2009
http://journals.lww.com/clinicalneuropharm/Abstract/2009/01000/Single_Dose_of_Fluoxetine_Increases_Muscle.1.aspx

The Lancet Neurology; Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial; Prof François Chollet, MD, et. al.; February 2011
http://www.sciencedirect.com/science/article/pii/S1474442210703148