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No full textPalo Alto Times
VOL. 22
PALO ALTO. CALIFORNIA, FRIDAY, OCTOBER 2, 1903
NO. 19
PROFESSIONAL CARDS
MEDICAL
D1
R. H. L. STEINLE
CMYtCUN AND SUMCLCOM
OAcr.l'-rklBtAablk. Heal* i 10 t -n.1 : lo *
a.m. Tel-phone Main iji. Realdenec. W»».
err? St. aadCbauInx Are. Tel. Black *oj
DR. NATHALIE SELLING .
Stanford Bu.ia.ng. Palo Alio
X-RAY LAUORATURV
ll.iur.. * \Q i. T.-l tllBCk SI.
HG. WYCKOFF. M, D. ~***-^
Physician and Surgeon
OSlccand Kfi:d«w.i;4««iT''»iM PaloAlK
I'hour Red yaj. OSce hour* 10 10 11 ■ n
» 10 4 aad j taSp.ra
C B. VAN DALSEM. M. D.
O, - Physician and Surgeon
IT.tr, rooma 3 and 4. Madlaotl Tliiilti btjtlll-
lug: residence mi Lititoln Ave, Tri ntn-e ml
lot. roaltlimco black til. Hour* lli.SJ lo U;3:Si
t.i .'. ..1.[I : 10 S; SuDdaj 1. *dU ! I: • '
DRO BONO PUBLICO
Regular Qualified Veterinary Surgeon
My diploma Hang* In mj oSicu nod la rasta-
lertd according (o law. Thirty-acviro year*
practte*. Doa=*-»tlc animala irraln] Bcicotia-
cally (or all dt»c»B»-n. No cbarcr rnr namlna-
Uo*. a C. HALUY, SK Uol-ar.lI J evaane.
Peto Alio. Cat.
HL. BENEPE : '■-
• VETERINARY
OmcriM Humli.irot Are. Palo Alto
Uouautiailon Free. Tat. blue IMS
JOHN 0. VARIAN
0 SCIENTIFIC MASSEUR
Treataoaacaac patient".'bom". Or bla rooma,
It Ma.ilHia Tholia' tlulldHtK. 1'lijiklenaccnn-
DCDd bla trcr.tiu-nt. Honra, II lu l»; 1 IdZaS);
7 I" r. Tclepbooe Black 103
DENTISTS
DR
L. M. PLACE
DCNTiaV
Hours 1 in 6. Patrick llulldlng. ovor Stanford
rilJIII.l*.') Tr IrJilK.iic Win lr Am I'Bill Alio
rjEO. BLAKESLEY LITTLE, D. D..S.
01
AlU
D1
DENTIST
Omen. klorrl. HuIUIIdk. Utili.rmliy Avo.i'ato
AlW.Cat.
tR. CHAS S COE
DENTIST.
BtuitioL JTa»caf7.
Office Id l-atkin.ca Block. Palo Alio. CI.
DR. CHARLES W. DECKER
DENTIST
Offlca aud RcklucncD. UolkorallT A
Main Ufflc*
r>HAS. S. McCOWEN. D. 0. S.
O DENTIST
Office hotira 9 to n a. in.. 1 to 5 p. m.
OtScc-Rooma J awl S. JUdlaoB-TholU bldg.
Phone Red 103 Palo Alto.Cat.
ATTORNEYS
NORMAN E. MALCOLM
ATTORNEY AT LAW
NOTARY PUBLIC CITY ATTORNEY
Careful attention Blvon lo all IckbI and notary work. Ituomi IMS Parkinson lllin-k
Life Insurance. Accident Insurance. Money
ALTER RODGERS
ATTORNEY AT LAW
Room >. MadUoa-TboUe blk. I-eto Alto
PUNS FOR II CO-OPERATINE
W
CAMUEL W. CHARLES
O ATTORNEY AT LAW
Noi.rr work AiicodecTio. PaHtlaaoa* lllocV
1-akiAlto.
MUSIC TEACH EHS
M
ISS MAY ADAMS
TEACMLH OF PiaNO
ate of Tie King Conservatory of Muilo.
T«l Bryant St., Palo Alto
Miss
GRACE CLARK
I a*traction In
PIANO. KanatOMY 4 VOICC CULTURE
Studio. *» Wavcrly Street. Pato Ako, Cal.
HB. PASHORE MISS MARY PASMORE
TeacheroT Teacher of
aiHOINO VIOLIN
14T Emftraon Street Sit Homer Avenue
Will receive pupils on Mondays
Address ItM Washington St., nan Krenclaoo
MRS.
GEO. L. NOYES
p D. SMITH
\J. VOCAL INSTRUCTOR
Old Italian Method. Pnpll New Eoflaad
Cooler*awry. Myron W. Wbllnay and ChM. «.
AdBtnu. Boiton. Kealdeace *." llawtborae
avenue, I*alo Alto.
M
RS. ELLA B. McDOWELL
VOCAL INSTRUCTION
M'
ISS DOROTHY GOODSELL
VOCAL TEACHER
Naaa aTeime. San Franelaeo.
MISCELLANEOUS
PRIMARY SCHOOL
I and KINDERGARTEN
413 Cowper St. near Unlveratty Aveaua.
The Pilaiary Srbool re-optaa Monday Aug.
i;tii llouragtoit am.* •"■,«!• v
The Kindergarten re-oprna Mont ay Aag.
■ - i.-.-i ]■ in. J11.1 urn ror either
igo CBRTRCDB N. BROWN, rttactpal
w
(TRS. STOWE'S SCHOOL . t
921 RjiTaxa St-eet
PYtaaari aaal Graaassr yraJaa. Preparaa tor
Blfh School. ladlvldaal Iaatractloa a apec-
uiiy rail term, bagiaa Wadaeedaj. Beet- Jtt
Cornmittee from Board of
Trade Makes a Full
Report.
A Second Meeting Will Be Held on
Next Monday Night to Take
Further Action.
Tlio ronitH tuouUiifC culled for litBt
Bight at MiiUiVh hull, to conuiilcr tbu
cooporatko dairy project, watt well
attended and it innrkod intercut (n the
matter was abown. Ttio meeting was
organizud by electing Ceo. It. Park-
imjOQ t'bnirmaii and C S. Downing
eecretary. I'rofeaaur Roberta, Dean
of the Corar-11 Agricultural Collese,
who araa to apeak, bad been aoddeoly
culk-d to Shu Frmicinco nud wae "no-
able to bo preaetit.
Or. C. Q, Unldwln huh leqitcstcd
to explain the object of the meeting.
He said In tnibetttucn Mint he had made
u thorough liiYentlgutiou of dairy eon*
ditlous.. Ho hud vlnlted Berkeley
twice .imi »ceu the rcportaof tbedairy
apeclslltit* of the State University.
Tbeve reports abow that there i» nut
in Northern California a tingle ;leao,
aanitary dairy. 1'nlo .Mto U in no
worse 01 no better condition than
other sections'. Such dairies, bow-
ever, are 11 couHtiint menace to health.
It saenia to be impoaaihlu strictly to
enforce) it municipal dairy ordinance
such a» Palo Alto Iiiih adopted. The
matter of hnrlug souud, good milk
must be accomplished by aoaie plau
aucb as suggested of a cooperative
dairy, tjnuducUd oa liocx vilfb will
make it telf-supporting, but which
will eliminate the question of personal
gain. The time seemed to have arrived wbou tbe people bore must take
definite action or abtuidon the project.
.Mi. lluldwiti then presented the report prepared by the committee mimed
by tbe Board of Trade. Ho said that
information rcceivLvL^fter tbo report
was written showed that the expense
of pumping wator might make the
cost of raising rIibIim, somewhat more
than estimate* Id the report. Tbe
report was as follows, the members of
tbe committee being Messr*. Baldwin,
Black, Ferguson, J. F. I'arkinr-on
nud Professor Bobeits-:
To tbo Citizens of Pulo Alto:
Your committee tmvo looked into all
suitable lundu ollerod (or nolo or lease
within three miles of tbo center of
Palo Alto. Have riaitod or bare
bad experts reports upou all dairies
furnishing milk to San Francisco.
Have learned cost of hay as purchased
or raised by dairymen; amount of
alfalfa rfer acre produced by irrigation
and amount of water used per acre,
ilavo bad estimate* made by experts
upon cost of improvements required
to produce pure'mid souud milk nud
to deliver It lo good coudiliou. Have
bad levels run ou the lund dually
chosen; have ascertained what can
be 'lun- fur management and are thus
prepared with all tbe data required
to recommeDd action in detail.
We are ready to justify tbe following recommendations aDieatimates:
I. We recommeud tbat a corporation be formod; that shares of stock
be sold at eT>0 oacb to tbe amount of
115,000, believing that all other Deeded fundi- up to a gross amount of
•05,000 can bo provided from othor
sources.
II. We recommaod that one hundred and forty three acre* of tbe
Raveoswood Stock Farm, owned by
Mr. Crow, be porcbaaed, with its improvements, for tbe son of 40,000.
After dednotlug tbe value of these Improvements to our enterprlae It makes
tbe coat of tho bare land 9257 per
acre, and your oumramlttee bellevea
it'to bo on tbo whole by far tbo beat
purchase to make, on aooount of
character of tbe soli, grade of the laod
for cultivatlou, character f tbe land
anlted for coraj for exerclee of cattle,
it being special.y dry in arbiter, and I
on acvoaot of the character of tbe,
water nupply, a matter of prime
Importance.
III. We recommend tbat bnlidbigs
be ercoted for milking aod oaro of
feed; a milk bouse with refrigerator
and gterillzlDg fiajitH, a pumping
plant, and tbat "H« bundrrd bead of
good cow* bo ptvnihaaed tooetber with
daittSaTj • waarona, etc., within three
moawiba. f /;?--"
IV. Wa tacomtaaod that the management be under direction of a Board
of Directors cosaliting of our best
business niou who shall bo asked to
do tho work for the public benefit lu
tho Mtinut i mi ii that is showu by our
town trustees. That they no itsslstod
by a staff uf experts Including experienced nii-ii In dalrylug and .rricn'.l,.,- ■
a board of physicians aud a chemist
and bactorlologiat and tbat three melt
furnish tbe acfeotldc basis of tbe work
aud do It for tbe pablic good lo the
Kiiuf way that the board .of directors
giro tbelr name and Influence nud
fluunrlal wisdom. As au executive
manager we recommend tbo employment of tho best graduate uf tbo
dahy department of tbe University of
California at a reasonable salary and
with a farmer of experience In raislug
alfalfa by Irrigation we will thus bo
organiied for successful work.
V. Believing tbat tbe one practical
question to be Drat settled is whether
915.000 cau be subscribed by the
citizens of Palo Alto to carry out alibi njllWI rTM.acreuied aud
project aud that ull other etope cau|tn",lk'1 lt'udf *
be oucily titkou wo recommend that «< request of I),
strenuous ellort be made at this meeting to aociire the taking of as rnaiiy
of tbe :i(»0 shares of stock us possible,
and that this meeting rnjso a cltlzona'
committee of lire to plocc all unsold ' ^l,Mt^°|i"lul
stock within forty-eight hours it pot'
nV 100 miner's lncboa will Irrigate
Sjt) acres In alfalfa. A well pumping
9C&) gallons a minute would supply:
thia volume of water, Tbe gravel
bffwrlng strata In this locality contains
Arte »nu4, which presses around the
pipes and prerents sulllclent inflow of
water to pump so largo a quantity
from uuo well. Nine wells pumping ■
•acti 100 galluus a uilnute could tie
oi.erutod cheaply aud would furnish
ao ample supply on IIiIm basis. Home;
present questioned whether this
Rtftotiut of water woultl prove sufficient to Irrigate alfalfa laud here,
mud there was a dlflerence, of opinion I
i>. to the amount of water tbat could
bv pumped.
Subscription blanks were circulated
Dd i)ulle a sum of money was:
pltrdged. But tbe matter asj new to
most uf thotto present and It was sug-,
gestetl that more tlmo be given «ud ;
other meetings held. .Mr. .Morris
thought this tbe most important mutter ever before our people and sug- :
grated a union Sunday night meeting.'
li was, ou motion, decided to bold
another meeting on next Monday
night.
otlon the report of the com-:
vole of
tbutiks tendered the members. By
L. Sloan, who was u
meiiiljerof the committee but hud bean
utiidile to act with it, his name huh
taken from the com in it too.
It Is emphatically urged that tbe
attendance lie glveu
the meeting Monday bight, Come
libTc, ta Oidir Tbir~deflnl"te answeri»uib*r ^ou "P*61 lo *mk« ,,ock or
can be glveu lo Mr. Crow; for. ta;tt,t- Toe mrtter Is cf aecided im-
caso we cannot make with reasonable jiwrt«c4r-*i,Dd its success will I* of
assurance au answer by Monday, Mt. \*Tvul »dran<*Be to Palo Alto.
Ciow must close a lease for which be
is holden by nrrangemout previously
made.
To Influence cltlzoua to take this
stock, wo urge the following considerations:
1. By putting in 915,000 tbua we
are provldiug against a repetition of
the scourge of fever so freeb in ou:;
SHOWERED WITH RICE.
e muriiage of Erneot Wilson and
Minn Bertha Noltemeler mil eonr-iim-
innted a tbe bride's home lu San
Francisco on Wednesday eveniug,
remouy being prouounevd by
Rev. Bnrr M. Woedeu. There were
ut only tbe families of tbe bride
memories, and which has cost ourf1™ K"»"nj. Tbe bride was cbarm-
citizena not less tbau 975,000 lo ab-! In« ia a dn** of ct**m e"*!1" *•« «"'
solute outlay at the lowest estimate1
that has been made. We thus pro
vide as certainly us we can ugniust
scarlet fever, typhoid feror, diphtheria, tuberculosis and other diseases
being conveyed lu milk by every precaution known to science, exercising
bite taffeta, and carried white
cnriiHtious. .Miss Edna Wilson, tbe
maid of honor, wan prettily gowned
lu white nrgitiidie. Mr. and Mr*.
Wilson weut south yesterday nfter-
nouu and were somewhat oinburrussed
to huvo a party of friends board the
every ktioivii inethod to make milk'iniu uure witD P^nty of rice aud
as safo aa tho best water. As It Is K00*1 wishes. They will no at home
today we are taking fearful risks from ] lu ^^ Alteofty.o;hriaj bridal tour,
uncleuliness, from water supply, bad
aerating aud cooling devices, not to'
ei>eak of unwholesome preservatives, I ,
V, . . . . ., , iJnini-s t.aireti lioth employed lit \ i
which hare canned iio many deaths of , ., -, .,...'. * .
, , . i ., i ilervoort s livery born: got into a
iufuiits u a neigtilioniig city no; one , . . . *_ , . „
. . ... , ,.,. ; fracas in which (uirseii used it bn
knows what tho health and QODalUoOl. „,,, . . ,, , •*[?
, , ». , , ,,, ,, i hat nn Hitter, to punM) i in *~
of owners nntl their famines or tbo I _,, , ,__.,_ ,
milkers or even the .stock Itself Is
Six-foot Extonflion Table,
rouml lop -18 Inolics in di-
nmcter, •! Ifga mid renter
(►nst, tieufly curved
♦ I4.6U
.Six-foot Extension Table,
round top 4 incites in
diatnctiT, (juurter - snwt-d
oak, pqUnro Venetian leps
Six-foot Extension Table,
boovy box moulding, ridiiv
curved vqusro pedestal
♦24.50
Square Top
Extension Tables
Six-ftKil HurdwxHid Exten-
llon Table, .12x40 in. top,
wmi-round li'gs, strong and
Bervk'fiiblc.
•7.«0
Six-foot Kxtension. Table,
quarter-sawed. Ouk, top 40
\!n in., t\'.:\>-.\ !cj.- and-
bniid-rarvril daw feet
mjao
Six-fot.i Bxtonslon Tnblo,
ton |Sx Is in., piano finish,
goltlen quartered oak, moo-
dve legs.artlstioally curved
feet ' 120.00
Wo carry in stink upwards of liftv itylei of Dining
Tables, landed direct from Mitliigun factories
nud marked al a price thai
keeps them moving rapidly.
Stoves
Gasoline, Oil Stoves. Air Tight Heaters
Cook Stoves and Steel Ranges
X^^^N^^^^^X^^^^^^^-^*^^^^^^
TWENTY DAYS.
A few nights ago Henry
litter i
upon these milk ranches.
'1. By thus securing a model milk
supply, better lu all respects tbau
alleged beating of a bursa. tiarseu
was iirrented on a charge of iihhuuH
and buttory and was given a jury trial
before Justice Charles on Wednesday.
hi iv, iii'iii-i ill nil iv3in.-i.io lumi „ „ ,\ , - ,
, . at.! . . P. B. Oakford was pnoSOOt ug attor-
dow exists upou this coast and equal , „ ,„ „ *, " \, .
ney and H. W. fluskey appeared for
tbe defense. Both Rltter and (iarseu
are strangers here aud their teatiniouy
was flatly contradictory, ami there
Itneeees. The jury,
found Carson guilty as
to tbe beet eastern practices, we secure the beat possible public notice
and instead of sufleriug permanent
material loss ou account of ourlaloj
. „ , , . were no vithcr
experience «tt tdiall make permanent1. _
. , , r liowevi-r,
aud large commercial gain.
It Is tho belief of your commit-
teo that at 91.50 per pint and 92.50
per quart per month by raising all
bay and grain feeds upon the farm
tbo s'tovk cau secure an annual divl
dend of alx per cent and cau be
doubled In value Id ten years. Thus
tbe stock will maintain it- par value
aod will be easily salable
Thia belief la based upon a careful
detail study of cost of irrigation anil,
all tho expenses of a well operated
plant toi producing milk and tbo com
m it teo are prepared at this time to
answer uuy questions which may bo
hero asked upon any detail.
Tbe* chairman would like to add
that his own fear Is tbat tbe stock
will become ao valuable aa to be gatb'
ered In by a few and tbe place run
too distinctly for profit. lie wishes
to express the hope tbat tbe stockholders will agree to be satisfied with snob
a profit as will malntatu the. value of
tbe stock at par und will return to all
milk users lu proportion to tho
amount they use all profit above such
an amount rdi), farther, tbat tbey will
agree to turn over the plant at cost
or at an appraised value to tbe city
of Palo Alto at aoy time tbe city may
be authorized and may desire to take
It orer.
Tbe report wae discussed wltb
special refereuoe to tbe Crow ranch.
Mr. Baldwin said tbat tbe question
of water supply would modify tbe
recommendatioti m regard to thia par*
tloulsT.iaod. Another tract of eqosJ
size sod ejqiyuly good oould be bad
at the same price, and the Crow land
could mH be held after next Monday.,
The discuss ton of the cost of Irrlfs-
tion followed. In Southern Callfor-
oharged and yesterday the court Imposed a sentence of twenty days' imprisonment in tho county Jail.
THE RIFLE CLUB.
Tbe Palo Alto Rille Club has leased
from Miss Creer a tract of land near
tbe end of Cbaonlng lane, to be used
as a target range. A building,
- 1'izSO feet, has been erected for a
clab house and the rauge has been
fitted up at a total expense of 9200.
The Drat regular practice about wilt
be held on October 11th. It Is desired tbat all who aro Interested In
rifle shooting become mem.mm of tbe
clab. Tbe dues are light and tbe
■port will be excellent, as there ate a
nrtmber o/ floe marksmen In tbe club.
(Ue Tit Children's Shoes
Because we have the widths and sizes, proper
shapes, and the quantity of stock to fit from.
Let us lit your child properly.
Our range of prices will accommodate your
pocket-hook. jj
§ FREE! 3
IF IT FAILS
FREE LECTURE.
Dr. J. May, optician, will give
■Isioopticau entertainment entitled
"The Highways sod Byways of Jerusalem" at thachapol, Slaofoad Unl
varsity, next Tuesday evening, October 0. it will be under tho auspices
of the V. M. C. A. and le free. A
general Invitation la oxtouded. The
doetor'a long sojourn lu the auclent
city of David and bis collection of One
rlewa, give assurance of so Interest-
log hour.
H Our Poison Oak Remedy %
B»— IF IT CURES —£
y~ IT'S SOc at -~*g
ft WEINGARTNER & CO. nucuniot .k«k ^3
e7s44444.4U444i44444444444444444444^
WOMAN'S CLUB.
' The Woman's Clab will bold Its
first regular meeting next Wednesday
afieriioon at three o'clock. Mrs.
bctarlne Brigga of the Tehama atreet
2*ursss* Home will talk to tbs Isdles
about the "Neighborhood Work" In
which she has been engaged for several years. As thia work la of special
latsreat to young women they are Invited to be present ss go seta of tbs
Clab
Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial
No full textBackground: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy.Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388.Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p<0·0001).Interpretation: Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice
Feasibility of reporting results of large randomised controlled trials to participants:experience from the Fluoxetine or Control under supervision (FOCUS) trial
No full textObjectives: Informing research participants of the results of studies in which they took part is viewed as an ethical imperative. However, there is little guidance in the literature about how to do this. The Fluoxetine or Control Under Supervision Trial (FOCUS) randomised 3127 patients with a recent acute stroke to six months of fluoxetine or placebo and was published in Lancet on 5th December 2018. The trial team decided to inform the participants of the results at exactly the same time as the Lancet publication, and also whether they had been allocated fluoxetine or placebo. In this report, we describe how we informed participants of the results. Design. In the 6 month and 12 month follow-up questionnaires, we invited participants to provide an email address if they wished to be informed of the results of the trial. We re-opened our trial telephone helpline between 5th December 2018 and 31st March 2019. Setting: UK Stroke servicesParticipants: 3127 participants were randomised. 2847 returned 6 month follow-up forms and 2703 returned 12 month follow-up forms; the remaining participants had died (380), withdrawn consent or did not respond.ResultsOf those returning follow-up questionnaires, a total of 1845 email addresses were provided and a further 50 people requested results to be sent by post. Results were sent to all email and postal addresses provided; 309 emails were returned unrecognised. Seventeen people replied, of whom three called the helpline and the rest responded by email. ConclusionIt is feasible to disseminate results of large trials to research participants, though only around 60% of those randomised wanted to receive the results. The system we developed was efficient and required very little resource-and could be replicated by trialists in the future. <br/
Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial
No full textBackground
Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.
Methods
FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762.
Findings
Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months.
Interpretation
Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.
Funding
UK Stroke Association and NIHR Health Technology Assessment Programme
