This pragmatic pilot study assessed the use of fluoxetine and calcium in a population of 68 victims of musculoskeletal trauma. The setting was not reported, and no comparator group was specified. The primary outcomes included the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI).
Secondary outcomes were not reported. At a follow-up of 41.6 months, the study authors stated they were unable to demonstrate a measurable benefit to mental health or physical function. Specific numerical results for the primary outcomes were not provided in the available data.
Safety and tolerability data, including adverse events, serious adverse events, discontinuations, and general tolerability, were not reported. Funding sources and potential conflicts of interest were also not reported. Key limitations include the inability to demonstrate benefit and the absence of detailed safety or efficacy metrics.
The practice relevance suggests developing an effective, acceptable, time-limited treatment strategy that could be safely implemented by non-mental health care providers for victims of musculoskeletal trauma. However, the lack of demonstrated benefit and missing safety data currently limits the ability to recommend this approach.
View Original Abstract ↓
Status: COMPLETED | Phase: PHASE2
Condition(s): Musculoskeletal Injury
Intervention(s): Fluoxetine (DRUG), Calcium (DRUG)
Musculoskeletal trauma is one of the leading causes of disability in the United States and its negative quality of life impact extends beyond that of physical recovery. More than 50% of victims of musculoskeletal trauma suffer lasting mental health issues following their injury. These symptoms can develop across all spectrums of patients with a variety of injury severities. Previously, this research team developed a ten-step program with the aim of developing fostering coping mechanisms in trauma patients. We were unable to demonstrate a measurable benefit to their mental health or physical function. This has been mirrored in other studies as well; talk therapy and support groups are not a strong enough intervention for some patients.
We hypothesize that a subset of the trauma population would benefit from medical treatment for their depressive and anxious symptoms in the early recovery period. Given the limited resources of mental health systems, it would be ideal for their surgical providers to be able to manage safely their post-injury mental health issues during their surgical follow up. This is a pragmatic pilot study to develop an effective, acceptable, time-limited treatment strategy that could be safely implemented by non-mental health care providers for victims of musculoskeletal trauma.
Detailed: Rationale
Over 50% of victims of musculoskeletal trauma suffer prolonged depressive and anxious symptomology following their initial injury. This is an independent risk factor for prolonged mental and physical disability. In previous research by the study team in orthopedic trauma patients without previous diagnosis of psychiatric illness, we have demonstrated 28% of these patients had depressive symptomology and 40% had anxiety symptomology 3 months following their traumatic injury. \[1\] Mental health resources are limited, placing the bulk of patient care on the orthopedic surgeons and primary care physicians. Support groups, self-help programs and talk therapy, while valuable, have not demonstrated measurable efficacy for this patient population. We hypothesize that a subset of the tr
Primary Outcome(s): BDI-II - Beck Depression Inventory-II; BAI - Beck Anxiety Inventory; PSQI - Pittsburgh Sleep Quality Index
Enrollment: 68 (ACTUAL)
Lead Sponsor: University of Florida
Start: 2021-09-01 | Primary Completion: 2025-02-17
Results posted: 2026-04-14