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Combination of
Olanzapine Atypical antipsychotic
Fluoxetine SSRI
Clinical data
Trade names Cinol Forte, Cinol Plus, Depten-OZ, M-Olan Plus, Oladay-F, Olanex-F, Olapin Forte, Olapin Plus, Olorest-F, Symbyax
AHFS/Drugs.com entry
Pregnancy cat.
Legal status
Routes Oral
ATC code N06CA03
 YesY (what is this?)  (verify)

The drug combination 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]

Medical uses[edit]

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[edit]

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 black box warning stating that it could increase the risk of suicide in patients ages 24 and under. The warning also states that olanzapine/fluoxetine may increase the risk of death in elderly patients with dementia-related psychosis.[1]


  1. ^ a b c d e Symbyax Prescribing Information. Eli Lilly and Company. 2010. http://pi.lilly.com/us/symbyax-pi.pdf
  2. ^ Grohol, J. "FDA Approves Symbyax for Treatment Resistant Depression." Psych Central. http://psychcentral.com/blog/archives/2009/03/23/fda-approves-symbyax-for-treatment-resistant-depression/
  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. ^ a b Drugs.com http://www.drugs.com/pdr/symbyax.html

External links[edit]