Fluoxetine for Maintenance of Remission and to Improve Quality of Life in Patients with Crohn's Disease: a Pilot Randomized Placebo-Controlled Trial

Previous studies have shown that antidepressants reduce inflammation in animal models of colitis. The present trial aimed to examine whether fluoxetine added to standard therapy for Crohn's disease [CD] maintained remission, improved quality of life [QoL] and/or mental health in people with CD...

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Bibliographic Details
Published in:Journal of Crohn's and colitis 2017-04, Vol.11 (4), p.509-514
Main Authors: Mikocka-Walus, Antonina, Hughes, Patrick A, Bampton, Peter, Gordon, Andrea, Campaniello, Melissa A, Mavrangelos, Chris, Stewart, Benjamin J, Esterman, Adrian, Andrews, Jane M
Format: Article
Language:English
Subjects:
Adult
Antidepressive Agents, Second-Generation - therapeutic use
Crohn Disease - drug therapy
Cytokines - blood
Double-Blind Method
Female
Flow Cytometry
Fluoxetine - therapeutic use
Humans
Immunity, Cellular - drug effects
Male
Pilot Projects
Quality of Life
Short Report
Surveys and Questionnaires
Treatment Outcome
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Summary:Previous studies have shown that antidepressants reduce inflammation in animal models of colitis. The present trial aimed to examine whether fluoxetine added to standard therapy for Crohn's disease [CD] maintained remission, improved quality of life [QoL] and/or mental health in people with CD as compared to placebo. A parallel randomized double-blind placebo controlled trial was conducted. Participants with clinically established CD, with quiescent or only mild disease, were randomly assigned to receive either fluoxetine 20 mg daily or placebo, and followed for 12 months. Participants provided blood and stool samples and completed mental health and QoL questionnaires. Immune functions were assessed by stimulated cytokine secretion [CD3/CD28 stimulation] and flow cytometry for cell type. Linear mixed-effects models were used to compare groups. Of the 26 participants, 14 were randomized to receive fluoxetine and 12 to placebo. Overall, 14 [54%] participants were male. The mean age was 37.4 [SD=13.2] years. Fluoxetine had no effect on inflammatory bowel disease activity measured using either the Crohn's Disease Activity Index [F(3, 27.5)=0.064, p=0.978] or faecal calprotectin [F(3, 32.5)=1.08, p=0.371], but did have modest effects on immune function. There was no effect of fluoxetine on physical, psychological, social or environmental QoL, anxiety or depressive symptoms as compared to placebo [all p>0.05]. In this small pilot clinical trial, fluoxetine was not superior to placebo in maintaining remission or improving QoL. [ID: ACTRN12612001067864.].
ISSN:1873-9946
1876-4479
DOI:10.1093/ecco-jcc/jjw165