Prozac is one of the most widely prescribed antidepressants, but according to a new study, it also shows great promise in the recovery of people left moderately to severely disabled from strokes.
While it's not FDA-approved as a drug that can help stroke patients enhance their motor skills, Prozac is certainly not alone in being a double-duty drug.
There are other drugs that perform dual roles, including a skin cancer cream used to smooth out your facial wrinkles, a baldness drug to protect against prostate cancer, and a drug for enlarged prostate and possibly prostate cancer that may stop baldness.
Once a drug has been approved for one use, doctors can prescribe it "off-label" when it is shown to be useful for something else. And an increasing number of drugs are prescribed in this manner. Off-label use of medicines accounts for about one fifth of all prescriptions, according to a 2008 study in the New England Journal of Medicine.
Many of these off-label uses meet with controversy and questions about their value, particularly since the FDA has not yet approved them. (As a result, drug companies cannot advertise off-label uses.)
Though the hair loss drug finasteride is recommended by some medical organizations as a preventative measure against prostate cancer, many doctors say that such a use is inefficient and ill-advised.
But in many other cases, the alternative uses are well-known in the medical community -- though perhaps not among the general public -- and are regularly exploited.
Prozac, also known as fluoxetine, is approved by the FDA for the treatment of major depression, obsessive-compulsive disorder, panic disorder and a number of other conditions.
But a group of French researchers found the drug may have another use. Their study, published in The Lancet, found that giving fluoxetine after a stroke could help sufferers improve their motor skills.
The authors gave 118 patients treated at 9 different medical centers either fluoxetine or a placebo for three months starting 10 days after their strokes. Those patients who received fluoxetine showed a 40 percent greater improvement in motor function than the placebo group. The same patients who took fluoxetine were also significantly less depressed than their placebo counterparts.
According to the authors, the results suggest that fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) offer "a new pathway that should be explored further in the treatment of acute ischemic stroke."
Neurologists not involved in the research say while the study is small and the patients may not be representative of all those who suffer strokes, the findings warrant further study.
"The effects are so striking that I think it's really important to recognize this as a potential treatment for improving recovery in patients with significant motor deficits," said Lee Schwamm, vice chair of the Department of Neurology at Massachusetts General Hospital in Boston.
Previous smaller studies have suggested that SSRIs can play a role in recovery from a stroke, so the current study's findings are not entirely new.
Experts say they do not know exactly how Prozac helps in stroke recovery.