Symbyax: Difference between revisions
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| pregnancy = Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.{{citation needed}} | | pregnancy = Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.{{citation needed}} | ||
| legal = [[USLegal:Prescription only|Rx-only]] in US. Carries the '''antidepressant Boxed Warning''' for suicidality in children/adolescents/young adults and the atypical-antipsychotic '''Boxed Warning''' for increased mortality in elderly dementia patients<ref name="symbyax-label" /> | | legal = [[USLegal:Prescription only|Rx-only]] in US. Carries the '''antidepressant Boxed Warning''' for suicidality in children/adolescents/young adults and the atypical-antipsychotic '''Boxed Warning''' for increased mortality in elderly dementia patients<ref name="symbyax-label" /> | ||
| mechanism = <vote slug="symbyax-mech-claim">Olanzapine is a thienobenzodiazepine atypical neuroleptic with D2, 5-HT2A/2C, H1, M1, and α1 antagonism, providing both antimanic effect and adjunctive mood-stabilization. Fluoxetine is a selective serotonin reuptake inhibitor with antidepressant effect. The combination addresses the dual challenge of bipolar depression | | mechanism = <vote slug="symbyax-mech-claim">Olanzapine is a thienobenzodiazepine atypical neuroleptic with D2, 5-HT2A/2C, H1, M1, and α1 antagonism, providing both antimanic effect and adjunctive mood-stabilization. Fluoxetine is a selective serotonin reuptake inhibitor with antidepressant effect. The combination addresses the dual challenge of bipolar depression, risk of antidepressant-induced manic switch and inadequate response to mood stabilizer monotherapy, by pairing the fluoxetine antidepressant with the olanzapine mood-stabilizing/antimanic anchor.</vote> Metabolic effects (weight gain, dyslipidemia, glucose dysregulation) dominate the long-term tolerability profile; routine metabolic monitoring is standard<ref name="symbyax-label" />. | ||
}} | }} | ||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 04:45, 23 May 2026
Atypical neuroleptic (olanzapine), Antidepressant (fluoxetine, SSRI), Mood stabilizer, Fixed-dose combination
Olanzapine / Fluoxetine
Symbyax
Experience
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Summary
Classes
Common uses
Bipolar I depression (acute)0, Treatment-resistant major depression (after at least two SSRI failures)0
Pharmacy
Starting dose
6/25 mg PO once daily in the evening; titrate within range 3/25 to 18/75 mg by clinical response and tolerability
Preparations
Capsules: 3/25, 6/25, 6/50, 12/25, 12/50 mg olanzapine/fluoxetine
US FDA Max
18 mg olanzapine / 75 mg fluoxetine per day
Pharmacology
Routes
Oral
Onset
Mood improvement at 1-3 weeks; full effect 4-6 weeks
Duration
24 hours
Half-life
Olanzapine ~30 hours; fluoxetine 1-4 days (norfluoxetine 7-15 days)[1]
Bioavailability
Olanzapine 60% (oral); fluoxetine high (oral)[1]
Pregnancy
Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.[citation needed]
Legal status
Purported mechanism
Olanzapine is a thienobenzodiazepine atypical neuroleptic with D2, 5-HT2A/2C, H1, M1, and α1 antagonism, providing both antimanic effect and adjunctive mood-stabilization. Fluoxetine is a selective serotonin reuptake inhibitor with antidepressant effect. The combination addresses the dual challenge of bipolar depression, risk of antidepressant-induced manic switch and inadequate response to mood stabilizer monotherapy, by pairing the fluoxetine antidepressant with the olanzapine mood-stabilizing/antimanic anchor.0 Metabolic effects (weight gain, dyslipidemia, glucose dysregulation) dominate the long-term tolerability profile; routine metabolic monitoring is standard[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Symbyax (olanzapine / fluoxetine HCl), Eli Lilly, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021520s041lbl.pdf