{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T17:24:48Z","timestamp":1783790688332,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are no effective treatments for multiple system atrophy (MSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to assess the efficacy and safety of the serotonin reuptake inhibitor fluoxetine (40\u2009mg\/d) for the symptomatic treatment of MSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a double\u2010blind, parallel\u2010group, placebo\u2010controlled, randomized trial in patients with \u201cprobable\u201d MSA. The primary outcome was the change from baseline to week 12 in the mean total score of the Unified MSA Rating Scale (UMSARS Parts I\u2009+\u2009II). Secondary outcomes included change from baseline to week 6 in total UMSARS, and change from baseline to week 12 in the Scales for Outcomes in Parkinson Disease\u2013Autonomic Dysfunction, Beck Depression Inventory, and different domains of the MSA\u2010Quality of Life Questionnaire. Exploratory outcomes included change from baseline to week 12 in the UMSARS Parts I and II separately and change from baseline to week 24 in the total UMSARS score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 81 patients were randomly assigned, with no significant difference in the primary outcome (\u22122.13\u2009units [95% confidence interval, CI, \u22124.55 to 0.29]; <jats:italic>P<\/jats:italic>\u00a0=\u20090.08). There was a greater reduction on fluoxetine in the change from baseline to 12\u2010week in UMSARS Part II (exploratory outcome: \u22121.41 units [95% CI, \u22122.84; 0.03]; <jats:italic>p<\/jats:italic> = 0.05) and in MSA\u2010QoL emotional\/social dimension (secondary outcome: \u22126.99 units [95% CI, \u221213.40; \u22120.56]; <jats:italic>p<\/jats:italic> &lt; 0.03). A total of 5 deaths occurred (3 on fluoxetine and 2 on placebo).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MSA\u2010FLUO failed to demonstrate fluoxetine superiority over placebo on the total UMSARS score, whereas trends in motor and emotional secondary\/exploratory outcomes deserve further investigation. \u00a9 2021 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.28569","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T08:28:10Z","timestamp":1617265690000},"page":"1704-1711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Fluoxetine for the Symptomatic Treatment of Multiple System Atrophy: The MSA\u2010FLUO Trial"],"prefix":"10.1002","volume":"36","author":[{"given":"Olivier","family":"Rascol","sequence":"first","affiliation":[{"name":"French Reference Center for MSA, Centre d'Investigation Clinique de Toulouse CIC1436, Departments of Neurosciences and Clinical Pharmacology, NS\u2010Park\/FCRIN Network, NeuroToul COEN Center University Hospital of Toulouse, INSERM, University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-4319","authenticated-orcid":false,"given":"Val\u00e9rie","family":"Cochen de Cock","sequence":"additional","affiliation":[{"name":"Department of Neurology Beau Soleil Clinic  Montpellier France"},{"name":"EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Pavy\u2010Le Traon","sequence":"additional","affiliation":[{"name":"French Reference Center for MSA, Department of Neurosciences Centre d'Investigation Clinique de Toulouse CIC1436, UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), University Hospital of Toulouse, INSERM, University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Foubert\u2010Samier","sequence":"additional","affiliation":[{"name":"French Reference Centre for MSA, NS\u2010Park\/FCRIN Network University Hospital Bordeaux  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Thalamas","sequence":"additional","affiliation":[{"name":"Centre d'Investigation Clinique de Toulouse CIC 1436, Department of Clinical Pharmacology University Hospital of Toulouse, INSERM, University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Sommet","sequence":"additional","affiliation":[{"name":"Centre d'Investigation Clinique de Toulouse CIC 1436, Department of Clinical Pharmacology University Hospital of Toulouse, INSERM, University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Rousseau","sequence":"additional","affiliation":[{"name":"Centre d'Investigation Clinique de Toulouse CIC 1436, Department of Clinical Pharmacology University Hospital of Toulouse, INSERM, University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9069-6512","authenticated-orcid":false,"given":"Santiago","family":"Perez\u2010Lloret","sequence":"additional","affiliation":[{"name":"Centro de Altos Estudios en Ciencias Humanas y de la Salud (CAECIHS) Universidad Abierta Interamericana (UAI)\u2010Consejo Nacional de Investigaciones Cient\u00edficas y T\u00e9cnicas (CONICET)  Buenos Aires Argentina"},{"name":"Faculty of Medicine Pontifical Catholic University of Argentina  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Toulouse Parkinson Expert Center, Centre d'Investigation Clinique de Toulouse CIC1436, NS\u2010Park\/FCRIN Network University Hospital of Toulouse, INSERM, University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Philippe","family":"Azulay","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille Universit\u00e9 et Assistance Publique\u2010H\u00f4pitaux de Marseille; 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