Prozac® is in the news again. It's good news, of course. It seems that a single dose of fluoxetine (Prozac®, Sarafem®), improved scores on movement tests and activated brain areas responsible for movement in patients who had recently suffered strokes.

Before stocking up on Prozac®, it should be said that these findings have yet to be repeated. However, researchers undertook this study based on earlier observations that showed antidepressants enhance recovery after stroke. It seems that physicians noticed improvements in their patients who were on antidepressants, and wondered whether the drugs were directly affecting the recovery of brain areas that control movement, or whether patients simply put more effort into physical rehabilitation programs because of the antidepressant properties of the drugs.

The results from this French study were published in the Journal of the American Neurological Association in December, 2001. According to the investigators, the results suggest that the drug can directly speed functional recovery in people who have suffered a stroke.

The study was small, involving only 8 patients. They were evaluated 2 to 3 weeks after their strokes. Patients were chosen who had experienced limited strokes that affected only their movement, not their ability to understand or follow instructions.

Each individual performance on simple tasks such as rapid finger tapping or grip strengthening was assessed. The brain study was conducted with functional magnetic resonance imaging (fMRI) during the performance of simple movements.

The investigators found that the single dose of fluoxetine, given to the participant only a few hours before their assessments, was enough to significantly improve speed and strength on the finger tapping and grip tests, compared with the placebo - which is a sugar pill. This improvement correlated with a distinct fMRI activation of certain areas of the brain known to be involved in directing movement.

The researchers also noted that the drug's efficacy depended on the patient practicing the test several times, which supports the theory that the most effective way to apply these drugs would be to combine them with physical therapy.

Dr. Detre, a neurologist at the University of Pennsylvania, who wrote an editorial accompanying the article that appeared in the Journal of Neurology, explained that because patient selection, imaging, and data analysis were carefully carried out, the results are highly believable. However, since the study used only a single dose of drug, the results do not have immediate implications for long-term management of patients recovering from stroke, he said.

Interestingly, the antidepressant qualities of fluoxetine do not take effect after a single dose. So the findings from this study strongly support the idea that the drug directly enhances the performance of brain cells that direct movement. However, the researchers also noted that fluoxetine may have another indirect effect of improving a person's attention to the tasks involved.

Isabelle Loubinoux, Ph.D., of the French National Institute of Health and Medical Research in Toulouse, who was a lead author on the study, said that they must confirm these results with long-term, chronic treatment in a large number of patients, before fluoxetine and similar drugs can be prescribed for motor recovery following a stroke.

So, stay tuned, because there will no doubt be more news about this over the next little while.