Fluoxetine + Olanzapine

Indications

Fluoxetine + Olanzapine is used for: Depression Associated with Bipolar I Disorder, Treatment of Resistant Depression

Adult Dose

Depression Associated with Bipolar I Disorder Indicated for acute depressive episodes in bipolar I disorder Initial: 25 mg/6 mg PO qDay in evening If needed, may titrate with 25-50 mg fluoxetine/6-12 mg olanzapine; not to exceed 75 mg/18 mg per day Treatment of Resistant Depression Indicated for treatment resistant depression (ie, major depressive disorder in patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode) Initial: 25 mg/6 mg PO qDay in evening If needed, may titrate with 25-50 mg fluoxetine/6-12 mg olanzapine; not to exceed 75 mg/18 mg per day

Child Dose

Depression Associated with Bipolar I Disorder Indicated for acute depressive episodes in bipolar I disorder in children and adolescents aged 10-17 years <10 years: Safety and efficacy not established 10-17 year Initial: 25 mg/3 mg PO qDay in evening If needed, may titrate with 25-50 mg fluoxetine/6-12 mg olanzapine; not to exceed 50 mg/12 mg per day

Renal Dose

Administration

Contra Indications

Hypersensitivity to any component Concomitant thioridazine, pimozide Coadministration with MAOIs

Precautions

Hypertension, hepatic impairment, slow metabolizers Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn (see Pregnancy) Pupillary dilation occurs following use of many antidepressant drugs may trigger an angle-closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy Anaphylactoid reactions (eg, bronchospasm, angioedema, and urticaria) alone and in combination, reported

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Fluoxetine + Olanzapine : Common Nausea Vomiting Diarrhea Constipation Dryness in mouth Weight gain Sleepiness Orthostatic hypotension (sudden lowering of blood pressure on standing) Dizziness Muscle rigidity Restlessness Tremor Delayed ejaculation Anorgasmia (decreased o

Mechanism of Action

Fluoxetine: Inhibits CNS neuron serotonin reuptake with minimal or no effect on norepinephrine or dopamine reuptake; does not bind to alpha-adrenergic, histamine, or cholinergic receptors Olanzapine: Potent antagonist of dopamine 1-3, histamine H1, serotonin 5-HT2A and 5-HT2C, and alpha1-adrenergic receptors; shows moterate antagonism for 5-HT3, and muscarinic M1-5 receptors; binds to GABA-A, benzodiazepine, and beta-adrenergic receptors