The antidepressant fluoxetine, better known by the brand name Prozac, might be able to treat more than just mood disorders. New research finds that it may reduce the risk of developing dry age-related macular degeneration (AMD), a leading cause of poor vision and blindness.
Researchers at the University of Virginia studied Prozac's impact on AMD in two different ways.1 They examined the drug’s effects on animal models and evaluated data from health insurance companies on people who were taking fluoxetine.
Based on these findings, the authors of the study are urging that clinical trials be conducted to test fluoxetine as a treatment for dry AMD. The October study was published in the journal Proceedings of the National Academy of Sciences.
“Our study suggests that Prozac may be preventative,” Bradley Gelfand, PhD, study author and assistant professor at the University of Virginia, told Verywell in an email. “That this drug, which has been around for nearly 50 years, may have this new therapeutic property, was the most surprising aspect."
Currently, there are no Federal Drug Administration (FDA)-approved treatments for dry AMD.2
What Is Age-Related Macular Degeneration?
Macular degeneration is damage to the central part of the retina, an area called the macula, where your eyesight is sharpest.3 The result is blurriness or loss of the central part of your vision. Macular degeneration can happen with age and is the leading cause of vision loss in older people. Dry age-related macular degeneration is caused then the macular gets thinner with age.
Why Prozac May Work
The idea of testing fluoxetine against AMD came from a surprisingly young researcher working in Gelfand’s lab.
“An enterprising high school student in my laboratory, Meenakshi Ambati, made the observation that Prozac shares certain chemical similarities to another experimental compound that is being investigated for AMD and other inflammatory disorders,” he said. “Based on this observation, we started looking at whether Prozac can interfere with inflammatory pathways and whether its use was associated with an altered risk of AMD development.”
Fluoxetine is commonly prescribed as a treatment for clinical depression and obsessive-compulsive disorder in adults and in children as young as 7 years old.4
As an antidepressant, it is in a category called selective serotonin reuptake inhibitors.
The researchers found that it also binds to and inhibits a chemical called HLRP3. A chemical that binds to HLRP3 would inhibit an inflammatory response in the central part of the retina and potentially protect the vision.
To test whether fluoxetine could inhibit HLRP3, the research team at the University of Virginia created a computer model and found that fluoxetine could bind to HLRP3. They then found that fluoxetine could do this in mice.
Because fluoxetine is already widely used, the researchers decided to look for any evidence that it had an effect on AMD by looking at two databases of records from health insurance companies. The records included information from more than 100 million Americans.
The research team looked at the incidence of age-related macular degeneration in people who were prescribed fluoxetine.
"Our research suggests that people with clinical depression taking Prozac have reduced risk of developing AMD compared to people with depression taking other antidepressants,” Gelfand said.
What This Means For You
Fluoxetine isn't available just yet to prevent dry AMD, but it could be in the future. There are lifestyle changes you can make to help prevent AMD, you can read more about them here.
Researchers say the next steps will be to see if these findings hold up in clinical trials.
“In future studies, we are interested in knowing whether people who are at a high risk of AMD development, because of family history, age, smoking, etc., may benefit from taking Prozac,” Gelfand said. “We are currently working on the question of whether those with preexisting AMD may benefit from Prozac as well.”
Fluoxetine is already on the market in the U.S. and physicians can prescribe it for conditions other than depression. But more research needs to be done before it can be used for preventing or treating macular degeneration.
Vitamins and Supplements for Macular Degeneration
“Our studies are too preliminary for ophthalmologists to start prescribing Prozac to patients for the purpose of AMD risk prevention,” Gelfand said. “I’d like to stress that people should not start taking Prozac (fluoxetine) for the purposes of reducing AMD risk until more research can be done to confirm our findings and to better understand the risks and benefits of taking it.”
However, because fluoxetine has been already tested in clinical trials and has been used for years, it may be easier to bring to the drug market.
This could mean if clinical trials demonstrate benefits from using it, fluoxetine could be approved in much less time than it would take for a new and untested drug. It is also available generically, which would make it less expensive than a new drug.