fluoxetine and olanzapine Health Article

Generic name(s):

fluoxetine and olanzapine

Brand name(s):

fluoxetine-olanzapine, Symbyax

What is the most important information I should know about fluoxetine and olanzapine?

This medication is not for use in psychotic conditions that are related to dementia. Olanzapine has caused fatal heart attack and stroke in older adults with dementia-related conditions. Do not take fluoxetine and olanzapine together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), rasagiline (Azilect), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Olanzapine can cause high blood sugar (hyperglycemia). Symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. If you are diabetic, check your blood sugar levels on a regular basis while you are taking olanzapine.

SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking fluoxetine and olanzapine, do not stop taking the medication without first talking to your doctor.

What is fluoxetine and olanzapine?

Fluoxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Olanzapine is an antipsychotic medication. These drugs affect chemicals in the brain.

The combination of fluoxetine and olanzapine is used to treat depression caused by bipolar disorder (manic depression).

Fluoxetine and olanzapine may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking fluoxetine and olanzapine?

This medication is not for use in psychotic conditions that are related to dementia. Olanzapine has caused fatal heart attack and stroke in older adults with dementia-related conditions. Do not use fluoxetine and olanzapine if you are using any of the following drugs:

• pimozide (Orap);

• thioridazine (Mellaril); or

• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam).

Serious and sometimes fatal reactions can occur when these medicines are taken with fluoxetine and olanzapine. You must wait at least 14 days after stopping an MAO inhibitor before you can take fluoxetine and olanzapine. You must wait 5 weeks after stopping fluoxetine and olanzapine before you can take thioridazine (Mellaril).

Before taking fluoxetine and olanzapine, tell your doctor if you are allergic to any drugs, if you smoke, or if you have:

• liver disease;

• heart disease, high or low blood pressure, or a history of heart attack or stroke;

• diabetes;

• seizures or epilepsy;

• glaucoma;

• paralytic ileus (a stomach disorder);

• enlarged prostate; or

• a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take fluoxetine and olanzapine.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking fluoxetine and olanzapine, do not stop taking the medication without first talking to your doctor. Fluoxetine and olanzapine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give fluoxetine and olanzapine to anyone younger than 18 years old without the advice of a doctor.