Olanzapine/fluoxetine

Olanzapine/fluoxetine (trade name Symbyax, created by Eli Lilly and Company) is a single capsule containing the atypical antipsychotic olanzapine and the selective serotonin reuptake inhibitor (SSRI) fluoxetine. Olanzapine/fluoxetine is primarily used to treat the depressive episodes of bipolar I disorder as well as treatment-resistant depression.[1]

Olanzapine/fluoxetine
Combination of
OlanzapineAtypical antipsychotic
FluoxetineSelective serotonin reuptake inhibitor
Clinical data
Trade namesSymbyax, Cinol Forte, Cinol Plus, Depten-OZ, M-Olan Plus, Oladay-F, Olanex-F, Olapin Forte, Olapin Plus, Olorest-F
AHFS/Drugs.comSymbyax
Pregnancy
category
  • AU: C
  • US: C (Risk not ruled out)
    Routes of
    administration    		Oral
    ATC code
    Legal status
    Legal status
    Identifiers
    KEGG
     NY (what is this?)  (verify)

    Medical uses

    Olanzapine/fluoxetine was approved by the U.S. Food and Drug Administration (FDA) to treat the depressive episodes of bipolar I disorder in 2003.[1] In 2009, it was granted approval for the treatment of treatment-resistant depression.[2]

    Olanzapine/fluoxetine, or other antidepressant/antipsychotic combinations, are sometimes prescribed off-label for anxiety disorders,[3] eating disorders,[4] obsessive–compulsive disorder (OCD),[5] and posttraumatic stress disorder (PTSD).[6]

    Side effects

    Possible side effects of olanzapine/fluoxetine include all those of the two component drugs: olanzapine and fluoxetine. Common side effects include suicidal thoughts, increased appetite, weight gain, drowsiness, fatigue, dry mouth, swelling, tremor, blurred vision, and difficulty concentrating.[1]

    Olanzapine/fluoxetine could produce a severe allergic reaction and should not be used if the patient has previously experienced an allergic reaction to either fluoxetine or olanzapine.[7]

    Olanzapine is correlated with an increase in blood sugar. Patients with diabetes, or those at risk for developing it, require careful monitoring.[7]

    In rare cases, olanzapine/fluoxetine may cause neuroleptic malignant syndrome.[1]

    Like other SSRIs, olanzapine/fluoxetine carries a boxed warning stating that it could increase the risk of suicidal thoughts and behaviors in patients aged 24 and under. The warning also states that olanzapine/fluoxetine may increase the risk of death in elderly patients with dementia-related psychosis.[1]

    See also

    References
    1. "Symbyax Prescribing Information" (PDF). Eli Lilly and Company. 2010.
    2. Grohol, J. "FDA Approves Symbyax for Treatment Resistant Depression". Psych Central Blog.
    3. McIntyre R, Katzman M (2003). "The role of atypical antipsychotics in bipolar depression and anxiety disorders". Bipolar Disord. 5 Suppl 2: 20–35. doi:10.1111/j.1399-2406.2003.00061.x. PMID 14700010.
    4. Pederson KJ, Roerig JL, Mitchell JE (2003). "Towards the pharmacotherapy of eating disorders". Expert Opin. Pharmacother. 4 (10): 1659–78. doi:10.1517/14656566.4.10.1659. PMID 14521477.
    5. Koran LM, Ringold AL, Elliott MA (2000). "Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder". J Clin Psychiatry. 61 (7): 514–7. doi:10.4088/JCP.v61n0709. PMID 10937610.
    6. Stein MB, Kline NA, Matloff JL (2003). "Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study". Am J Psychiatry. 159 (10): 1777–9. doi:10.1176/appi.ajp.159.10.1777. PMID 12359687.
    7. Drugs.com https://www.drugs.com/pdr/symbyax.html
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