Olanzapine Fluoxetine

Suicidality in children and adolescents Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of olanzapine/fluoxetine or any other antidepressant in a child or adolescent must balance this risk with clinical need. 

Administer once daily in the evening, generally beginning with the 6 mg/25 mg capsule. While food has no appreciable effect on the absorption of olanzapine and fluoxetine given individually, the effect of food on the absorption of olanzapine/fluoxetine has not been studied. Dosage adjustments, if indicated, can be made according to efficacy and tolerability. Antidepressant efficacy was demonstrated with olanzapine/fluoxetine in a dose range of olanzapine 6 to 12 mg and fluoxetine 25 to 50 mg. The safety of doses above 18 mg/75 mg has not been... 

Special populations Use a starting dose of 6 mg/25 mg for patients with a predisposition to hypotensive reactions, patients with hepatic impairment, or patients who exhibit a combination of factors that may slow the metabolism of olanzapine/fluoxetine (eg, female gender, elderly, nonsmoking status). When indicated, perform dose escalation with caution in these patients. Olanzapine/fluoxetine has not been systemically studied in patients older than 65 years of age or in patients younger than 18 years of age. 

Bipolar depression Lithium, lamotrigine, olanzapine-fluoxetine combination... 

Zanarini MC, Frankenburg FR, Parachini EA A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder. J Clin Psychiatry 65 903-907, 2004... 

The olanzapine-fluoxetine combination is currently the only medication approved by the FDA specifically for the treatment of depression in patients with bipolar disorder. This indication was based on data from a double-bhnd, randomized study in which the combination was superior to both olanzapine monotherapy and placebo (Tohen et al. 2003). Treatment-emergent mania or hypomania did not occur more frequently in the olanzapine-fluoxetine combination group than in the placebo group during the acute trial. 

Lithium, lamotrigine, and olanzapine-fluoxetine combination therapy are first-line treatments for bipolar depression. The response... 

Tohen M, Vieta E, Calabrese J, et al Efficacy of olanzapine-fluoxetine combination in the treatment of bipolar I depression. Arch Gen Psychiatry 60 1079-1088, 2003... 

Betamethasone + Gentamicin S-Amlodipine + Losartan S-Amlodipine + Atenolol Pioglitazone + Glimeperide Glimeperide + Metformin Rosiglitazone + Glimeperide Tramadol + Paracetamol Ramipril + s(-) Amlodipine Olanzapine + Fluoxetine Ciprofloxacin + Ornidazole Quinapril + HCTZ (Hydrochlorothiazide)... 

In a 6-week double-blind study, subjects with obsessive-compulsive disorder who had failed to respond completely to fluoxetine alone (43 adults and one adolescent, mean age, 37 years, 26 women) received either fluoxetine + olanzapine (n = 22), or fluoxetine + placebo (n = 22) (70). Olanzapine was begun at 5 mg/day and titrated upwards to a maximum of 10 mg/day by as early as the second week. There were seven dropouts because of adverse events —five with olanzapine + fluoxetine (weight gain and shakiness) and two with fluoxetine + placebo (increased anxiety and emotional numbing). Mean weight gain was 2.8 kg with olanzapine + fluoxetine and 0.5 kg with fluoxetine + placebo. 

Rothschild AJ, Williamson DJ, Tohen MF, Schatzberg A, Andersen SW, Van Campen LE, Sanger TM, Tollefson GD. A double-blind, randomized study of olanzapine and olanzapine/fluoxetine combination for major depression with psychotic features. J Clin Psychopharmacol 2004 19 365-73. 

Fluoxetine has been specifically sfudied in combination wifh olanzapine (olanzapine-fluoxetine combination) wIfh excellenf resulfs for bipolar depression, freafmenf-resisfanf unipolar depression, and psychofic depression... 

HT2C antagonist actions plus serotonin reuptake blockade of fluoxetine add to the actions of olanzapine when given as Symbyax (olanzapine-fluoxetine combination)... 

Olanzapine-fluoxetine combination capsule (mg equivalent olanzapine/mg equivalent fluoxetine) 6 mg/25 mg, 6 mg/50 mg,... 

OLANZAPINE/FLUOXETINE HYDROCHLORIDE (Symbyax capsules olanzapine 6 mg/fluoxetine hydrochloride 25 mg, capsules olanzapine 6 mg/ fluoxetine hydrochloride 50 mg, capsules olanzapine 12 mg/fluoxetine hydrochloride 25 mg, capsules olanzapine 12 mg/fluoxetine hydrochloride 50 mg) Olanzapine/flnoxetine hydrochloride is an antidepressant. It is thonght that activation of 3 monoaminergic neural systems (dopamine, norepinephrine, and serotonin) is responsible for an enhancement of the antidepressant effect. 

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