Olanzapine/fluoxetine: Difference between revisions

{{Short description|Antidepressant medication}}

| Verifiedfields = changed

| Watchedfields = changed

| verifiedrevid = 447722434

| type = combo

| image = Olanzapine and fluoxetine.svg

| class2 = [[Selective serotonin reuptake inhibitor]]

| tradename = Symbyax, Cinol Forte, Olapin Forte, others

| Drugs.com = {{Drugs.com|ppa|olanzapine-and-fluoxetine}}

| DailyMedID = Olanzapine_and_fluoxetine

| pregnancy_AU = C

| pregnancy_US = C

| pregnancy_category =

| legal_US = Rx-only

| legal_US_comment = <ref name="Symbyax FDA label" />

| legal_status =

| routes_of_administration = [[Oral administration|By mouth]]

| ATCvet =

| ATC_prefix = N06

| ATC_suffix = CA03

| ATC_supplemental =

| KEGG_Ref = {{keggcite|changed|kegg}}

| KEGG = D10206

| CAS_number = 250603-12-4

'''Olanzapine/fluoxetine''' (trade name '''Symbyax''', created by [[Eli Lilly and Company]]) is a [[fixed-dose combination]] medication containing [[olanzapine]] (Zyprexa), an [[atypical antipsychotic]], and [[fluoxetine]] (Prozac), a [[selective serotonin reuptake inhibitor]] (SSRI). Olanzapine/fluoxetine is primarily used to treat the depressive episodes of [[bipolar I disorder]]<ref>{{Cite web |title=Tratamento medicamentoso dos transtornos bipolares - Transtornos psiquiátricos |url=https://www.msdmanuals.com/pt-br/profissional/transtornos-psiqui%C3%A1tricos/transtornos-do-humor/tratamento-medicamentoso-dos-transtornos-bipolares |access-date=2022-10-02 |website=Manuais MSD edição para profissionais |language=pt-BR}}</ref> as well as [[treatment-resistant depression]].<ref name="Symbyax FDA label">{{cite web | title=Symbyax- olanzapine and fluoxetine hydrochloride capsule | website=DailyMed | date=21 April 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6b28c424-0b7e-4b75-b090-f116b113554e | access-date=30 September 2020}}</ref><ref>{{cite journal | vauthors = Benazzi F, Berk M, Frye MA, Wang W, Barraco A, Tohen M | title = Olanzapine/fluoxetine combination for the treatment of mixed depression in bipolar I disorder: a post hoc analysis | journal = The Journal of Clinical Psychiatry | volume = 70 | issue = 10 | pages = 1424–1431 | date = October 2009 | pmid = 19906346 | doi = 10.4088/JCP.08m04772gre }}</ref>

==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.<ref name="Symbyax FDA label" /> In 2009, it was granted approval for the treatment of [[treatment-resistant depression]].<ref>{{cite web | author = Grohol, J. | title = FDA Approves Symbyax for Treatment Resistant Depression | work = Psych Central Blog | url = http://psychcentral.com/blog/archives/2009/03/23/fda-approves-symbyax-for-treatment-resistant-depression/ | access-date = 2010-07-17 | archive-date = 2017-12-26 | archive-url = https://web.archive.org/web/20171226073909/https://psychcentral.com/blog/archives/2009/03/23/fda-approves-symbyax-for-treatment-resistant-depression/ | url-status = dead }}</ref>

Olanzapine/fluoxetine, or other [[antidepressant]]/[[antipsychotic]] combinations, are sometimes prescribed [[off-label use|off-label]] for [[anxiety disorders]],<ref name="pmid14700010">{{cite journal | vauthors = McIntyre R, Katzman M | title = The role of atypical antipsychotics in bipolar depression and anxiety disorders | journal = Bipolar Disorders | volume = 5 | issue = Suppl 2 | pages = 20–35 | year = 2003 | pmid = 14700010 | doi = 10.1111/j.1399-2406.2003.00061.x }}</ref> [[eating disorders]],<ref name="pmid14521477">{{cite journal | vauthors = Pederson KJ, Roerig JL, Mitchell JE | title = Towards the pharmacotherapy of eating disorders | journal = Expert Opinion on Pharmacotherapy | volume = 4 | issue = 10 | pages = 1659–1678 | date = October 2003 | pmid = 14521477 | doi = 10.1517/14656566.4.10.1659 | s2cid = 38506292 }}</ref> [[obsessive–compulsive disorder]] (OCD),<ref name="pmid10937610">{{cite journal | vauthors = Koran LM, Ringold AL, Elliott MA | title = Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder | journal = The Journal of Clinical Psychiatry | volume = 61 | issue = 7 | pages = 514–517 | date = July 2000 | pmid = 10937610 | doi = 10.4088/JCP.v61n0709 }}</ref> and [[posttraumatic stress disorder]] (PTSD).<ref name="pmid12359687">{{cite journal | vauthors = Stein MB, Kline NA, Matloff JL | title = Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study | journal = The American Journal of Psychiatry | volume = 159 | issue = 10 | pages = 1777–1779 | date = October 2002 | pmid = 12359687 | doi = 10.1176/appi.ajp.159.10.1777 }}</ref>

==Side effects==

Possible side effects of olanzapine/fluoxetine include all those of the two component drugs: [[Olanzapine#Side effects.2C adverse reactions|olanzapine (side effects)]] and [[Fluoxetine#Adverse effects|fluoxetine (side effects)]]. Common side effects include suicidal thoughts, increased appetite, weight gain, [[somnolence|drowsiness]], [[Fatigue (medical)|fatigue]], [[Xerostomia|dry mouth]], [[Peripheral edema|swelling]], [[tremor]], blurred vision, and difficulty concentrating.<ref name="Symbyax FDA label" />

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.<ref name="drugscom">{{cite web | title = Symbyax | work = Drugs.com | url = https://www.drugs.com/pdr/symbyax.html }}</ref>

Olanzapine is correlated with an increase in blood sugar. Patients with [[diabetes]], or those at risk for developing it, require careful monitoring.<ref name="drugscom" />

In rare cases, olanzapine/fluoxetine may cause [[neuroleptic malignant syndrome]].<ref name="Symbyax FDA label" />

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]].<ref name="Symbyax FDA label" />

== See also ==

* [[Amitriptyline/perphenazine]]

* [[Aripiprazole/sertraline]]

* "[[California rocket fuel]]"

* [[Flupentixol/melitracen]]

* [[Tranylcypromine/trifluoperazine]]

* {{cite web | url = https://druginfo.nlm.nih.gov/drugportal/name/fluoxetine%20hydrochloride%20mixture%20with%20olanzapine | publisher = U.S. National Library of Medicine | work = Drug Information Portal | title = Fluoxetine hydrochloride mixture with Olanzapine }}

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