Fluoxetine in Progressive Multiple Sclerosis (FLUOX-PMS): study protocol for a randomized controlled trial

Melissa Cambron, Jop Mostert, Patrick Haentjens, Marie D’Hooghe, Guy Nagels, Barbara Willekens, Dorothea Heersema, Jan Debruyne, Wim Van Hecke, Luc Algoed, Nina De Klippel, Erwin Fosselle, Guy Laureys, Henri Merckx, Bart Van Wijmeersch, Ludo Vanopdenbosch, Wim Verhagen, Raymond Hupperts, Gerald Hengstman, Veronique Michiels, Annick Van Merhaegen-Wieleman, Jacques De Keyser

Currently available disease-modifying treatments acting by modifying the immune response are ineffective in progressive multiple sclerosis (MS), which is caused by a widespread axonal degeneration. Mechanisms suspected to be involved in this widespread axonal degeneration are reduced axonal energy metabolism, axonal glutamate toxicity, and reduced cerebral blood flow. Fluoxetine might theoretically reduce axonal degeneration in MS because it stimulates energy metabolism through enhancing glycogenolysis, stimulates the production of brain-derived neurotrophic factor, and dilates cerebral arterioles. The current document presents the protocol of a clinical trial to test the hypothesis that fluoxetine slows down the progressive phase of MS.