Deeks Emma D, Keating Gillian M
Wolters Kluwer Health, Adis, Auckland, New Zealand.
Drugs. 2008;68(8):1115-37. doi: 10.2165/00003495-200868080-00008.
Olanzapine/fluoxetine (Symbyax) is an oral once-daily fixed-dose combination of the atypical antipsychotic olanzapine and the selective serotonin reuptake inhibitor (SSRI) fluoxetine that is approved in the US for the treatment of depressive episodes associated with bipolar disorder in adults. Combination therapy with olanzapine plus fluoxetine is effective in the treatment of patients with acute bipolar depression. The combination improves depressive symptoms and symptom severity in this patient population, with an efficacy greater than that of olanzapine alone or lamotrigine. Furthermore, olanzapine plus fluoxetine is generally well tolerated. Although associated with weight gain and potential elevations in glucose, lipid and prolactin levels, the combination does not increase the risk of treatment-emergent mania. Additional placebo- and active comparator-controlled studies are required in order to confirm the efficacy of olanzapine/fluoxetine in the treatment of bipolar depression and to definitively position olanzapine/fluoxetine with respect to other agents. In the meantime, fixed-dose olanzapine/fluoxetine offers an effective and generally well tolerated first-line option for the treatment of acute bipolar depression.
奥氮平/氟西汀（Symbyax）是一种非典型抗精神病药物奥氮平和选择性5-羟色胺再摄取抑制剂（SSRI）氟西汀的口服固定剂量复方制剂，每日服用一次，在美国被批准用于治疗成人双相情感障碍相关的抑郁发作。奥氮平加氟西汀的联合疗法对急性双相抑郁患者有效。该复方制剂可改善该患者群体的抑郁症状和症状严重程度，疗效优于单用奥氮平或拉莫三嗪。此外，奥氮平加氟西汀一般耐受性良好。虽然与体重增加以及血糖、血脂和催乳素水平可能升高有关，但该复方制剂不会增加治疗中出现躁狂的风险。需要进行更多的安慰剂对照和活性对照研究，以确认奥氮平/氟西汀治疗双相抑郁的疗效，并明确奥氮平/氟西汀相对于其他药物的地位。在此期间，固定剂量的奥氮平/氟西汀为治疗急性双相抑郁提供了一种有效且一般耐受性良好的一线选择。
