A new University of Florida study published in the Journal of Orthopaedic Trauma suggests that starting fluoxetine soon after a traumatic musculoskeletal injury may help reduce post-traumatic stress symptoms during recovery while also improving pain-related outcomes.
The randomized controlled trial, led under the senior leadership of Jennifer E. Hagen, MD, and coordinated by Marissa Pazik, PhD, represents years of multidisciplinary collaboration between the UF Department of Orthopaedic Surgery and Sports Medicine, the Department of Psychiatry, and the Department of Anesthesiology.
Patients recovering from serious fractures often experience more than physical injuries. PTSD, anxiety, depression, and chronic pain can significantly affect recovery and quality of life. Because orthopaedic surgeons frequently remain the patient's primary point of contact after injury, the research team explored whether early treatment with the antidepressant fluoxetine (commonly known as Prozac) could improve both psychological and physical recovery.
In the study, patients who began fluoxetine shortly after surgery and continued treatment for nine months experienced a greater reduction in PTSD symptom severity than patients in the comparison group. Researchers also observed improvements in pain and social participation, with benefits continuing through one year of follow-up.
The publication builds upon ongoing research efforts within the UF Orthopaedic Trauma Division focused on identifying patients at risk for post-traumatic stress and integrating mental health considerations into orthopaedic care. Earlier work by the team established the feasibility of initiating treatment immediately after injury, while this randomized clinical trial provides encouraging evidence that early intervention may meaningfully improve patient outcomes.
The research was led by senior author Jennifer E. Hagen, MD, with first author Marissa Pazik, PhD. Additional contributors included Terrie Vasilopoulos, PhD, Ludmila de Faria, MD, Diana V. Rijo, BS, MaryBeth Horodyski, EdD, and Carol A. Mathews, MD, whose expertise in anesthesiology, psychiatry, clinical research, and orthopaedic trauma helped make the multidisciplinary study possible.
The findings highlight the importance of treating the whole patient — not only the injury — while laying the foundation for larger studies evaluating early interventions that support both mental and physical recovery after orthopaedic trauma.