Fluoxetine Evaluated as Treatment for EV-D68 Acute Flaccid Myelitis

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Fluoxetine is well tolerated but is not effective for patients with proven or presumptive enterovirus D68-associated acute flaccid myelitis (AFM), according to a study published online November 9 in Neurology.

               Kevin Messacar, MD, from the University of Colorado School of Medicine in Aurora, and colleagues compared serious adverse events (SAEs), adverse effects, and outcomes between fluoxetine-treated AFM patients (30 patients) and untreated controls (26 patients). 

             The researchers found no SAEs were reported among the 30 patients exposed to fluoxetine, and adverse effect rates were similar to those of control patients (47 vs 65%; P=.16). The summative limb strength score (SLSS) at initial examination was similar for the 28 patients treated with more than 1 dose of fluoxetine and those treated with 1 or no doses (mean SLSS, 12.9 vs 14.3; P=.31), but it was significantly lower at nadir (mean SLSS, 9.25 vs 12.82; P=.02) and latest follow-up (mean SLSS, 12.5 vs 16.4; P=.005). In a propensity-adjusted analysis, there was a 0.2 decrease and a 2.5 increase in SLSS from initial examination to latest follow-up for fluoxetine-treated and untreated patients, respectively (P=.015).

                 "The lack of an efficacy signal for the treatments for acute flaccid myelitis evaluated in this study emphasizes the need for development and prospective evaluation of more effective treatment and prevention strategies for this potentially devastating condition," Messacar said in a statement.