Olanzapine/fluoxetine combination for bipolar depression and other mood disorders: a review

Patients with bipolar disorder tend to experience most of their illness in the depressed phase. Existing antidepressant therapies are effective in bipolar depression but carry a risk of treatment-emergent mania or increased phase cycling. Other therapies such as lithium may not be particularly effective, or may not currently be licensed for the acute phase, such as lamotrigine. A combination of the antipsychotic olanzapine and the serotonin reuptake inhibitor fluoxetine has been investigated in both bipolar depression and other affective disorders such as psychotic depression and treatment-refractory depression. The combination's possible mode of action, pharmacokinetics, drug interactions, clinical efficacy and safety and tolerability have been reviewed.