Preliminary studies providing evidence of the neuroprotective effect of SSRIs in patients with Multiple Sclerosis (MS) by improving the metabolic function of axons. The aim of this, open label, randomized, controlled, one year follow-up prospective study was to investigate the effect of escitalopram in the prevention of relapses in women with MS.

Forty eight ambulating women with relapsing-remitting MS were randomly assigned to receive 10 mg of escitalopram per day (e-group, N=24) or to continued the study without medication as a control group (c-group, N=24). Neurological examination was performed, by the same neurologist, at baseline and at every regular (4 weeks) and additional visit after a suspect exacerbation.

During the study period 55 exacerbations occurred in 33/48 (68.7%) of the patients, and these were confirmed by the study neurologist. E- group patients’ present a mean of 0.8 (SD=0.8) and c-group patients’ a mean of 1.4 (SD=1.0) exacerbations per year. Patients treated with escitalopram present a statistically significant reduction in the mean number of MS relapses respect to the previous year (paired t-test, df=23, t=4.9, p< .001). There was no significant difference between the mean number of MS relapses during the year of the study and the previous year in c-group (paired t-test, df=23, t=-0.68, NS). The cumulative risk for relapse was 2.9 times higher for the controls than for escitalopram-treated patients (95% CI= 1.7- 5.1, p< .001).

This study provides evidence that escitalopram tends to decrease MS disease activity in women with MS.