Drilldown: Medicines

Olanzapine / Fluoxetine (1) · Valproate (valproic acid, divalproex sodium, sodium valproate) (1)

Depakote, Depakote ER, Depakene, Depacon (IV) (1) · Symbyax (1)

Research material · Classic Psychedelic · Stimulant · Opioid · Sedative-hypnotic · Phenethylamine · Tryptamine · Benzodiazepine · Botanical · [[:Category:Antihypertensives|Antihypertensive]] · Dissociative · Anticonvulsant · Antidepressant · Plant Medicine · Analgesic · Antiparkinsonian · Antipsychotic · Empathogen · Neuroleptic · Cathinone

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'"`UNIQ--vote-00000975-QINU`"' Hyperammonemic encephalopathy (consider in any unexplained CNS depression), thrombocytopenia, and polycystic ovary syndrome are characteristic chronic-use adverse effects beyond hepatic and pancreatic risks'"`UNIQ--ref-00000976-QINU`"'. (1) · '"`UNIQ--vote-00001549-QINU`"' Metabolic effects (weight gain, dyslipidemia, glucose dysregulation) dominate the long-term tolerability profile; routine metabolic monitoring is standard'"`UNIQ--ref-0000154A-QINU`"'. (1)

'"`UNIQ--vote-00000977-QINU`"', '"`UNIQ--vote-00000978-QINU`"', '"`UNIQ--vote-00000979-QINU`"', '"`UNIQ--vote-0000097A-QINU`"', '"`UNIQ--vote-0000097B-QINU`"' (1) · '"`UNIQ--vote-0000154B-QINU`"', '"`UNIQ--vote-0000154C-QINU`"' (1)

6/25 mg PO once daily in the evening; titrate within range 3/25 to 18/75 mg by clinical response and tolerability (1) · Seizures: 10-15 mg/kg/d divided BID-TID, titrate to therapeutic level (50-100 mcg/mL); bipolar mania: 750 mg/d divided, titrate (1)

125, 250, 500 mg delayed-release tablets (Depakote); 250, 500 mg ER tablets (Depakote ER); 125, 250 mg sprinkle capsules; 250 mg/5 mL syrup; 500 mg IV (Depacon) (1) · Capsules: 3/25, 6/25, 6/50, 12/25, 12/50 mg olanzapine/fluoxetine (1)

18 mg olanzapine / 75 mg fluoxetine per day (1) · 60 mg/kg/d (typically up to 3000 mg/d) (1)

IV (1) · Oral (2) · rectal (off-label use of injection) (1)

Anticonvulsant effect within days; mood-stabilizing effect 1-3 weeks (1) · Mood improvement at 1-3 weeks; full effect 4-6 weeks (1)

12 hours (IR); 24 hours (ER) (1) · 24 hours (1)

9-16 hours'"`UNIQ--ref-0000097C-QINU`"' (1) · Olanzapine ~30 hours; fluoxetine 1-4 days (norfluoxetine 7-15 days)'"`UNIQ--ref-0000154D-QINU`"' (1)

Olanzapine 60% (oral); fluoxetine high (oral)'"`UNIQ--ref-0000154E-QINU`"' (1) · ~100% (oral); highly (~90%) protein-bound, with non-linear binding above therapeutic levels (free fraction matters clinically in hypoalbuminemia)'"`UNIQ--ref-0000097D-QINU`"' (1)

'''Contraindicated for migraine prophylaxis in pregnancy; high teratogenic risk''' (neural tube defects, craniofacial anomalies, cardiac defects, cognitive/IQ impairment); avoid in women of childbearing potential without reliable contraception when alternatives exist'"`UNIQ--ref-0000097E-QINU`"' (1) · Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

[[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warnings''' for hepatotoxicity (especially children <2 with metabolic disorders), teratogenicity, and pancreatitis'"`UNIQ--ref-0000097F-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the '''antidepressant Boxed Warning''' for suicidality in children/adolescents/young adults and the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly dementia patients'"`UNIQ--ref-0000154F-QINU`"' (1)