Sixty-eight patients with high-energy orthopaedic trauma were randomized to receive fluoxetine (n=33) or calcium (n=35) for nine months. The primary outcome of interest was sleep efficiency, measured by the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included overall sleep quality and anxiety levels, measured using the Beck Anxiety Inventory (BAI). Outcomes were assessed at six weeks and three months postoperatively. Overall, the results showed that fluoxetine improved sleep efficiency significantly at six weeks compared to calcium (p < 0.001), but this effect was not sustained at three months (p = 0.78). Additionally, fluoxetine appeared to attenuate the correlation between anxiety and poor sleep at three months. These findings suggest that fluoxetine may have short-term benefits for sleep efficiency and anxiety following orthopaedic trauma.