TNF and lumbar disc herniation: In a lumbar disk herniation model, fluoxetine decreases TNF-α in the hippocampus (Cai et al., 2019), while in a chronic constriction injury model, it decreases proinflammatory cytokines in the plasma, increases IL-10, decreases myelin degeneration and leukocyte infiltration in peripheral nerves and decreases astrocyte activation in the spinal cord; additionally, it has better effects when combined with antidiabetic drugs (Murad and Ayuob, 2015).