comparison of the therapeutic effects of oral fluoxetine and topical clobetasol with topical clobetasol and placebo in vitiligo patients: a triple blinded placebo control clinical trial

Background :assess whether adding fluoxetine (20 mg daily) to topical clobetasol 0.05% is more effective than clobetasol with placebo for vitiligo. methods :triple-blind randomized clinical trial (crt) in isfahan, iran between 2022 and 2023. forty-one patients were randomized to: fluoxetine+clobetasol and placebo+clobetasol. lesions were photographed at baseline and after 3 months. two blinded dermatologists categorized improvement (mild, moderate, good, excellent) based on lesion size and perifollicular pigmentation. patient satisfaction (vas) and side effects were recorded. results :forty-one patients, 91 lesions (19 in the fluoxetine group, 22 in the control). significant baseline differences: more males and older age in the fluoxetine group. no difference in lesion improvement between groups (p = 0.879). more adverse effects with fluoxetine (p = 0.006); satisfaction was similar (p = 0.310). after adjusting for age/gender, no significant differences were found. conclusions :adding fluoxetine to topical clobetasol did not improve vitiligo outcomes compared with clobetasol alone.