Fluoxetine increases cerebral white matter NAA/Cr ratio in patients with multiple sclerosis.
Axonal degeneration in multiple sclerosis (MS) may be caused by mitochondrial dysfunction and is associated with decreased levels of N-acetylaspartate (NAA) as measured with 1H-magnetic resonance spectroscopy (MRS). Fluoxetine stimulates astrocytic glycogenolysis, which serves as an energy source for axons. Eleven patients with MS received fluoxetine orally 20 mg a day during the first week, and 40 mg a day during the second week. The mean NAA/Creatine ratio in cerebral white matter of the MS patients increased from 1.77 at baseline to 1.84 at the end of the second week (p=0.007). These findings show evidence for a reversible axonal dysfunction in patients with MS and provide a rationale for investigating whether fluoxetine has neuroprotective effects in MS.
Mostert
Jop P
JP
Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands. j.p.mostert@neuro.umcg.nl
Sijens
Paul E
PE
Oudkerk
Matthijs
M
De Keyser
Jacques
J
D000284:Administration, Oral; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage*; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D002540:Cerebral Cortex / Q000187:drug effects* / Q000378:metabolism; D003401:Creatine / Q000378:metabolism*; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000473:pathology*
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine