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Treating Bipolar Depression

A Combination Drug Approved to Treat Bipolar Depression

bipolarA recent study by Dr. Marcus Silva and colleagues, of the University of Brasilia, has found that the combination of the atypical antipsychotic olanzapine and the antidepressant fluoxetine (together trade named Symbyax) is efficient in treating the depressive phases of bipolar disorder.[1] The combination of olanzapine and fluoxetine has been FDA-approved for the treatment of bipolar depression for four years; however, this has been the only study to address the efficacy of the combination in treating bipolar depression, without focusing on a single drug class comparison.

What is bipolar depression?

Bipolar depression is a condition that can trouble patients suffering from bipolar disorder for three times as many days as any other mood episodes.1 Antidepressants alone can put the patient at risk for switching into mania or to have rapid cycling.2 Their confusing effects are still not completely understood in the treatment of bipolar disorder.[2]

First Line Treatments for Bipolar Depression

However, the combination of olanzapine and fluoxetine has been found to work very effectively for both mania and depression, and the combination of an SSRI antidepressant and an antimanic agent is now recommended among first-line treatments.[3] Other first-line treatments include monotherapy of olanzapine, valproate, lamotrigine, and lithium. In fact, during Silva and colleagues’ study, it was found that remission rates were high and relapse rates were low, compared with olanzapine alone.1

Adverse effects were present, as with any medicine, and the most notable were weight gain, somnolence, and sometimes tremors.1 These effects were comparable to those of olanzapine alone. Still, the quality of life for those treated with the combination had increased, with severity of symptoms lowered and no increase of mania seen.1



[1] Silva MT, Zimmermann IR, Galvao TF, Pereira MG. Olanzapine plus fluoxetine for bipolar disorder: a systematic review and meta-analysis. J Affect Disord. 2013;146:310-318. – See more at: http://www.psychiatrictimes.com/bipolar-disorder/olanzapinefluoxetine-combination-affirmed-bipolar-depression#sthash.vPO2a5Wt.dpuf

[2] Amit BH, Weizman A. Antidepressant treatment for acute bipolar depression: an update. Depress Res Treat. 2012;2012:684725. Epub 2012 Jan 27. doi:10.1155/2012/684725. – See more at: http://www.psychiatrictimes.com/bipolar-disorder/olanzapinefluoxetine-combination-affirmed-bipolar-depression#sthash.vPO2a5Wt.dpuf

[3] Nivoli AM, Colom F, Murru A, et al. New treatment guidelines for acute bipolar depression: a systematic review. J Affect Disord. 2011;129:14-26. – See more at: http://www.psychiatrictimes.com/bipolar-disorder/olanzapinefluoxetine-combination-affirmed-bipolar-depression#sthash.vPO2a5Wt.dpuf. bipolar.

One Comment

  • Garfield

    October 3, 2013, 6:01 pm

    You really constructed a lot of good stuff in your article,
    “Treating Bipolar Depression – Wellington Retreat”.
    I may become coming back again to ur web site in the
    near future. Thx ,Garfield

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