Prozac could be first treatment for blindness; Research suggests

National News

NEW YORK – JANUARY 4: Two bottles of Prozac are seen on a pharmacy shelf January 4, 2005 in New York City. The British Medical Journal (BMJ) sent the U.S.Food and Drug Administration documents submitted by an anonymous source that seem to show a link between Eli Lilly and Co.’s Prozac (fluoxetine) and suicide attempts and violence. (Photo by Stephen Chernin/Getty Images)

An antidepressant best known as Prozac could offer the first treatment for the leading cause of blindness among people over 50, new research from the University of Virginia School of Medicine suggests.

UVA’s Bradley D. Gelfand, PhD, and collaborators have found early evidence that the drug fluoxetine may be effective against atrophic (or “dry”) age-related macular degeneration, a condition that affects nearly 200 million people worldwide. The drug has shown promise in the scientists’ lab tests and animal models, and the researchers bolstered by their results by examining two huge insurance databases encompassing more than 100 million Americans. That analysis concluded that patients taking fluoxetine were less likely to develop atrophic macular degeneration (AMD).

Based on their findings, the researchers are urging clinical trials to test the drug in patients with AMD. If successful, they believe the drug could be administered either orally or via a long-lasting implant in the eye.

“These findings are an exciting example of the promise of drug repurposing, using existing medicines in new and unexpected ways,” said Gelfand, of UVA’s Center for Advanced Vision Science. “Ultimately, the best way to test whether fluoxetine benefits macular degeneration is to run a prospective clinical trial.”

The researchers believe fluoxetine works against AMD by binding with a particular agent of the immune system known as an inflammasome. This inflammasome, NLRP3-ASC, triggers the breakdown of the pigmented layer of the eye’s retina.

After conducting extensive bench research, Gelfand and his team tested fluoxetine and eight other depression drugs in lab mice to see what effect, if any, the drugs would have in a model of AMD. Fluoxetine slowed the progression of the disease, but the others did not, the scientists found.

Encouraged by their findings, the researchers looked at fluoxetine use among patients over age 50 in two enormous insurance databases. People taking the drug had a “significantly” slower rate of developing dry AMD, the researchers report in a new scientific paper outlining their findings.

They note that their approach, combining bench research with big-data analysis, could potentially facilitate the repurposing of existing drugs for many conditions, speeding new treatments to patients.

The researchers have published their findings in the scientific journal PNAS

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