The Effectiveness of Olanzapine/Fluoxetine Combination for Bipolar Depression
A recent analysis of the olanzapine/fluoxetine combination (OFC) has supported its effectiveness in treating the depressive phase of bipolar disorder. Compared with the sole treatment of olanzapine, OFC was found to be more effective, and with no more adverse effects.1 According to Dr. Marcus Silva of the University of Brasilia, these findings have presented an alternative therapy for those suffering from bipolar depression.1
Bipolar depression burdens patients for three times as many days as other mood episodes, and four years ago, OFC became the first FDA-approved acute treatment for bipolar depression.1 Treatment guidelines for bipolar depression often differ, as there is evidence that antidepressants increase the risk of promoting a mood switch to mania or rapid cycling.1 Still, despite numerous trials and analyses conducted on the subject of antidepressants and bipolar depression, the role antidepressants play is still quite unclear.1
However, four out of the five major consensus-developed guidelines state that the combination of an SSRI antidepressant and an antimanic agent is recommended among first-line treatments for bipolar depression.1 Currently, first-line treatments include OFC, olanzapine, valproate, lamotrigine, and lamotrigine with lithium.
Silva and colleagues conducted an analysis of four randomized clinical trials that met the inclusion criteria.1 They found that the response rate was significantly higher with OFC than with olanzapine alone or a placebo.1 Still, lamotrigine was the most effective treatment.1 However, the severity of symptoms and relapse rates were significantly lower with OFC than with lamotrigine or placebo.1 Adverse effects occurred more frequently with OFC when compared with lamotrigine; however, there were fewer serious adverse events.1
Silva and colleagues state that their findings conclude that the use of OFC, rather than some existing monotherapies, shows benefits in response, remission, quality of live, severity of symptoms, relapse, and discontinuation.1 In fact, no increased risk of mania was observed.1
 Bender, K. J. (2013, July 16). Olanzapine/Fluoxetine Combination Affirmed for Bipolar Depression. Psychiatric Times. Retrieved October 1, 2013, from http://www.psychiatrictimes.com/bipolar-disorder/olanzapinefluoxetine-combination-affirmed-bipolar-depression