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Article summary:
1. The FOCUS trial aimed to provide a precise estimate of the effects of fluoxetine on functional outcomes after stroke.
2. Results showed that fluoxetine did not improve functional outcomes at 6 months, but it did reduce the occurrence of depression and increase the frequency of bone fractures.
3. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.
Article analysis:
The article is generally reliable and trustworthy, as it is based on a large-scale, double-blind, randomised, controlled trial conducted in 103 hospitals in the UK with 3127 participants. The study was also registered with ISRCTN registry and funded by UK Stroke Association and NIHR Health Technology Assessment Programme. The authors have provided detailed information about the methods used in the study, including eligibility criteria, randomisation process, masking procedure and primary outcome measure (modified Rankin Scale). Furthermore, they have reported their findings accurately and objectively without any bias or promotional content.
However, there are some points that could be improved upon in terms of trustworthiness and reliability. Firstly, although the authors have reported their findings objectively without any bias or promotional content, they have not explored any potential counterarguments or presented both sides equally. Secondly, although they have reported possible risks associated with taking fluoxetine (i.e., increased frequency of bone fractures), they have not discussed other potential risks such as gastrointestinal side effects or drug interactions which may be associated with taking fluoxetine after stroke. Finally, although they have reported their findings accurately and objectively without any bias or promotional content, they have not discussed any potential limitations to their study such as selection bias or confounding factors which may affect their results.