Symbyax for Bipolar (Zyprexa and Prozac combination)
by Sarah from Bipolar-Lives
(US)
US BRAND NAME: Symbyax
GENERIC NAME: Olanzapine and Fluoxetine Hydrochloride
TYPE: Atypical antipsychotic combined with SSRI antidepressant
USE: Symbyax is used to treat bipolar depression as well as treatment resistant depression in patients who have been treated with other antidepressants that did not work well. Symbyax works on all 3 of serotonin, norepinephrine, and dopamine.
COMMENTS: Symbyax increases serotonin due to its Prozac component. It also causes an increase in dopamine and norepinephrine. It is believed the increase results from a synergistic effect between Zyprexa and Prozac. Preclinical trials reported a 232% increase in dopamine (compared to a 66% increase with just olanzapine or a 55% increase with just fluoxetine) and a 160% increase in norepinephrine (compared to an 89% increase with just fluoxetine or a 33% increase with just olanzapine). On the downside, you are also running the risk of (synergistically?) combining the worst side effects of atypical antipsychotics AND SSRIs.
EVIDENCE: An Eli Lilly study of patients with bipolar depression found that those on Symbyax showed greater improvement than the Zyprexa alone group and those on a placebo. Nearly 49 percent of the Symbyax patients remitted vs 32.8 percent of the Zyprexa alone patients vs 25.5 percent on a placebo. Back in 2003, Symbyax was the first drug approved by the FDA to treat bipolar depression.
SIDE EFFECTS: Include but not limited to: Diabetes, Hyperglycemia, Tiredness, Increased appetite, Weight gain, Blurred vision, Dry mouth, Feeling weak, Sleeping for long periods of time, Tremors (shakes), Swelling of hands and feet.
CAUTIONS: NOT to be used to treat behavioral problems in older adult patients who have dementia. People taking Symbyax should have lipid tests (fats in the blood), including triglyceride and cholesterol levels, at the beginning of treatment. They should have follow-up lipid tests during treatment. People may gain weight while taking Symbyax and should have their weight checked regularly during treatment. High blood sugar can occur if you have diabetes already or even if you have never had diabetes.
