Nine months of fluoxetine reduces post-traumatic stress symptoms and pain following traumatic musculoskeletal injury
In a non-blinded RCT, 33 patients receiving fluoxetine for 9 months after traumatic musculoskeletal injury showed a significant decrease in PTSD symptoms (estimate = -0.2, 95% CI: -0.4, -0.0) and pain (estimate = -0.1, 95% CI: -0.1, -0.0) over one year, while 35 patients receiving placebo (calcium) showed no significant change. No significant effects were found on depression, anxiety, or social isolation.
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Nine months of fluoxetine reduces post-traumatic stress symptoms and pain following traumatic musculoskeletal injury The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Nine months of fluoxetine reduces post-traumatic stress symptoms and pain following traumatic musculoskeletal injury
This conclusion is most relevant to: Adult survivors of high-energy traumatic musculoskeletal injuries admitted to a Level 1 trauma center (mean age ~42 years, 43% female).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Nine Months of Fluoxetine Aids in the Reduction of Posttraumatic Stress Symptoms following a Traumatic Musculoskeletal Injury: A Randomized Controlled Trial. (Journal of orthopaedic trauma, 2026) —
How It Works
The proposed biological pathway:
- ▸Fluoxetine increases serotonin availability
- ▸Modulates stress response circuits
- ▸Reduces hyperarousal and re-experiencing symptoms
- ▸Result: Decreased PTSD symptom severity and pain over 12 months
Who Might Benefit
Evidence fit by population:
- ▸Adult survivors of high-energy traumatic musculoskeletal injuries admitted to a Level 1 trauma center (mean age ~42 years, 43% female)
Recommended Dose
N/A (dose not specified in abstract)
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Non-blinded design (open-label) may introduce bias
- ▸Small sample size (n=68 total)
- ▸Single-center study limits generalizability
- ▸No significant effects on depression or anxiety, suggesting selective symptom improvement
Frequently Asked Questions
How long did patients take fluoxetine in this study?▼
Patients were randomized to receive fluoxetine or placebo for 9 months following their injury.
Did fluoxetine improve sleep in this trial?▼
Sleep was measured via the Pittsburgh Sleep Quality Index (PSQI), but the abstract does not report significant changes in sleep outcomes.
Was this study blinded?▼
No, this was a non-blinded (open-label) prospective randomized clinical trial.
What type of injuries were included?▼
High-energy musculoskeletal trauma, excluding injuries from ground-level falls or less.
References
- 1.Pazik M, Vasilopoulos T, de Faria L, Rijo D, Horodyski M, Mathews C, Hagen J. “Nine Months of Fluoxetine Aids in the Reduction of Posttraumatic Stress Symptoms following a Traumatic Musculoskeletal Injury: A Randomized Controlled Trial..” Journal of orthopaedic trauma, 2026. PMID: 42441660 DOI: 10.1097/BOT.0000000000003243