Antidepressant “Prozac” Could Treat Leading Cause of Blindness

A common antidepressant 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.

Fluoxetine, the antidepressant commonly known as Prozac, may be beneficial for the treatment of age-related macular degeneration. Researchers found Prozac significantly slowed the rate at which people over 50 developed AMD.

The atrophic form of age-related macular degeneration (dry AMD) affects nearly 200 million people worldwide. There is no Food and Drug Administration (FDA)-approved therapy for this disease, which is the leading cause of irreversible blindness among people over 50 y of age.

Vision loss in dry AMD results from degeneration of the retinal pigmented epithelium (RPE). RPE cell death is driven in part by accumulation of Alu RNAs, which are noncoding transcripts of a human retrotransposon.

Alu RNA induces RPE degeneration by activating the NLRP3-ASC inflammasome. It is reported that fluoxetine, an FDA-approved drug for treating clinical depression, binds NLRP3 in silico, in vitro, and in vivo and inhibits activation of the NLRP3-ASC inflammasome and inflammatory cytokine release in RPE cells and macrophages, two critical cell types in dry AMD.

Also fluoxetine, unlike several other antidepressant drugs, reduces Alu RNA–induced RPE degeneration in mice.

Finally, by analyzing two health insurance databases comprising more than 100 million Americans, a reduced hazard of developing dry AMD is seen among patients with depression who were treated with fluoxetine. 

Collectively, these studies identify fluoxetine as a potential drug-repurposing candidate for dry AMD.

CHARLOTTESVILLE, Va. (CBS19 NEWS) -- Nearly 200 million people worldwide suffer from age-related macular degeneration or loss of eyesight. A new study at the University of Virginia has found early evidence of a potential treatment.

UVA researchers have found that the antidepressant best known as Prozac could be the first effective treatment against age-related macular degeneration, which is the leading cause of blindness among people over the age of 50.

Dr. Bradley Gelfand said it all started when an Albemarle High School student volunteering in the lab decided to look at re-purposing medicines for diseases like AMD. She found similarities in the antidepressant Prozac and AMD.

“Prompted by this interesting observation, we did a lot of research in models of macular degeneration and found that indeed this Prozac appeared to be beneficial in those experimental models," said Gelfand.

"And then we really took it a step forward by looking at real-world data from people who take Prozac, looking at their health insurance records and what we found was that people who take Prozac were protected against or, excuse me, had a reduced risk at developing age-related macular degeneration.”

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

Not only are these findings a big step forward for age-related blindness, but Gelfand said it shows the promise of drug re-purposing or using existing drugs in new ways.

Getting a new drug approved by the U.S. Food and Drug Administration takes 10 to 12 years and costs around $2.8 billion. Gelfand says finding new uses for old drugs could be the future.