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Spotlight on Olanzapine/Fluoxetine in Acute Bipolar Depression

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Abstract

Olanzapine/fluoxetine (Symbyax®) is an oral once-daily fixed-dose combination of the atypical antipsychotic olanzapine and the SSRI fluoxetine that is approved in the US for the treatment of depressive episodes associated with bipolar disorder in adults. Combination therapy with olanzapine plus fluoxetine is effective in the treatment of patients with acute bipolar depression. The combination improves depressive symptoms and symptom severity in this patient population, with an efficacy greater than that of olanzapine alone or lamotrigine. Furthermore, olanzapine plus fluoxetine is generally well tolerated. Although associated with weight gain and potential elevations in glucose, lipid and prolactin levels, the combination does not increase the risk of treatment-emergent mania. Additional placebo- and active comparator-controlled studies are required in order to confirm the efficacy of olanzapine/fluoxetine in the treatment of bipolar depression and to definitively position olanzapine/fluoxetine with respect to other agents. In the meantime, fixed-dose olanzapine/fluoxetine offers an effective and generally well tolerated first-line option for the treatment of acute bipolar depression.

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Authors and Affiliations

  1. Wolters Kluwer Health | Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, Auckland, 0754, New Zealand

    Emma D. Deeks & Gillian M. Keating

  2. Wolters Kluwer Health, Conshocken, Pennsylvania, USA

    Emma D. Deeks & Gillian M. Keating

Authors
  1. Emma D. Deeks
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  2. Gillian M. Keating
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Correspondence to Emma D. Deeks.

Additional information

Adapted and reproduced from Drugs 2008; 68 (8): 1115–1137. The full text article[1] was reviewed by: R. Bottlender, Newham Centre for Mental Health, Queen Mary University of London, London, UK; J. Cookson, The Royal London Hospital, London, UK; T. Denko, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; H.C.R. Grunze, School of Neurology, Neurobiology and Psychiatry, University of Newcastle, Newcastle upon Tyne, UK; S. Kasper, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria. The manufacturer of the agent under review was offered an opportunity to comment on the original article during the peer review process. Changes based on any comments received were made on the basis of scientific and editorial merit. The preparation of the original article and this spotlight was not supported by any external funding

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Deeks, E.D., Keating, G.M. Spotlight on Olanzapine/Fluoxetine in Acute Bipolar Depression. CNS Drugs 22, 793–795 (2008). https://doi.org/10.2165/00023210-200822090-00006

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  • DOI: https://doi.org/10.2165/00023210-200822090-00006

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