Stroke: After a stroke, the use of fluoxetine for 6 months will affect the functional prognosis

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI).
According to reports, in the FLAME trial (Fluoxetine for Motor Recovery After Acute Ischemic Stroke), after acute ischemic stroke, Fugl-Meyer exercise was used to evaluate The scale measurement can improve the movement recovery of the upper and lower limbs
.

Subsequently, Cochrane conducted a systematic review of 52 randomized controlled trials of SSRIs for stroke rehabilitation in 4,059 patients, and concluded that SSRIs may improve disability.
However, in view of the limitations and heterogeneity of the research methods, more specific trials are needed.

.

Recently, AFFINITY (Evaluation of Fluoxetine in Stroke Recovery) reported that in 1280 acute (2-15 days) stroke patients, oral fluoxetine, 20 mg per day, for 6 months after acute stroke, and placebo In contrast, it did not improve the functional outcome at 6 months and increased the risk of falls, fractures and seizures
.

The AFFINITY trial continued to follow the surviving participants for 6 months after stopping the trial medication to check whether any effects of fluoxetine in the first 6 months continued or were delayed 12 months after randomization
.

Specifically, AFFINITY is a randomized, parallel-group, double-blind, placebo-controlled trial with 43 subjects in Australia (n=29), New Zealand (4) and Vietnam (10) from 2013 to 2019 Hospital stroke department recruited adults who had a clinical diagnosis of stroke and persistent neurological dysfunction (n=1280)
.

Participants were randomly assigned to oral fluoxetine 20 mg once a day (n=642) or matching placebo (n=638) for 6 months and followed up to 12 months after random assignment
.

They found that the average compliance of the trial medication was 167 days (SD 48), which was similar between random groups
.

Compared with placebo, patients assigned to fluoxetine had fewer recurrent ischemic strokes (14[2.
18%] vs 29[4.
55%]; P=0.
02) and no longer had significant recurrent ischemic strokes at 12 months Falls (27[4.
21%] vs 15[2.
35%]; P=0.
08), fractures (23[3.
58%] vs 11[1.
72%]; P=0.
05) or seizures (11[1.
71%] vs 8 [1.
25 %]; P=0.
64)
.

The important significance of this study is that it found that taking 20 mg of fluoxetine daily for 6 months after an acute stroke has no delayed or lasting effect on functional outcomes, falls, fractures or seizures 12 months after the stroke
.

Original Source:
Hankey GJ, Hackett ML, Almeida OP, et al.