Perelman School of Medicine of the University of Pennsylvania, Department of Psychiatry , Philadelphia, PA 19104-3309 , USA.
Expert Opin Drug Saf. 2014 Aug;13(8):1133-41. doi: 10.1517/14740338.2014.933804. Epub 2014 Jun 27.
Bipolar disorder and treatment-resistant depression (TRD) are common and recurrent conditions associated with significant disability, morbidity and mortality. Despite the clear need for effective treatments, only a few medications have been approved in the US for these indications. The combined formulation of olanzapine-fluoxetine (OFC) has been available for a decade now, thus a review on its safety profile and comparative efficacy is timely and can help clinicians to determine the benefit/risk profile of OFC within the context of other treatment alternatives.
This paper summarizes the rationale and evidence supporting the use of OFC for both bipolar I depressive episodes and TRD with a focus on safety and tolerability. Product labels and the search engine PubMed was used to obtain relevant information on this subject.
Although further comparative studies are needed, the literature confirms that the OFC is an effective treatment for bipolar I depressive episodes, as well as major depressive episodes that have not responded to several adequate courses of antidepressant therapy. Its use as a first-line treatment for bipolar I depressive episodes and at a higher rung of algorithms for patients with TRD is limited by its propensity to cause weight gain and associated metabolic symptoms.
双相情感障碍和治疗抵抗性抑郁症（TRD）是常见且反复发作的疾病，会导致严重的残疾、发病率和死亡率。尽管明确需要有效的治疗方法，但美国仅批准了几种用于这些适应症的药物。奥氮平-氟西汀（OFC）的联合制剂已经上市十年了，因此及时对其安全性和疗效进行评估可以帮助临床医生在其他治疗选择的背景下确定 OFC 的获益/风险特征。
本文总结了支持 OFC 用于治疗双相 I 型抑郁发作和 TRD 的原理和证据，重点关注安全性和耐受性。产品标签和搜索引擎 PubMed 被用于获取关于这个主题的相关信息。
尽管需要进一步的比较研究，但文献证实 OFC 是治疗双相 I 型抑郁发作以及对几种充分的抗抑郁治疗反应不佳的重性抑郁发作的有效治疗方法。由于其导致体重增加和相关代谢症状的倾向，OFC 被限制用于双相 I 型抑郁发作的一线治疗和 TRD 患者的治疗方案中的较高级别。
