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Symbyax Medication Profile

Bipolar Medications Library

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Updated August 31, 2011

In a press release on December 29, 2003, Eli Lilly and Company announced that the U.S. Food and Drug Administration (FDA) had approved Symbyax (pronounced SIMM-bee-ax) for the treatment of depressive episodes associated with bipolar disorder. Symbyax is a combination of olanzapine, the active ingredient in Zyprexa, and fluoxetine, the active ingredient in Prozac. It is the first FDA-approved medication for bipolar depression.

Indications
Symbyax is prescribed for the treatment of the depressive phase of bipolar disorder. Virtually all patients with this disorder experience the depressive phase commonly referred to as bipolar depression. Patients with bipolar disorder spend an average of one-third of their lives in the depressive phase of this illness.

"Medications that clinicians have traditionally used to treat bipolar patients in a depressive phase can often take several weeks to work and have the additional risk of sending the patient into a manic episode," said Ketter. "Having a medication that can provide symptom relief quickly, while avoiding mania, will be so important to physicians in effectively treating patients with bipolar depression, particularly because these individuals are at a high risk of suicide" (Lilly, January 2004).

Research
According to a study by Tohen et al published in the November 2003 issue of Archives of General Psychiatry, Symbyax helped to treat the symptoms of bipolar depression more effectively and at a significantly faster rate than placebo. In the pooled eight-week studies, patients in the Symbyax group experienced significantly greater improvement in depressive symptoms at weeks one, three, four, six and eight, compared with patients taking placebo. That robust symptom improvement was sustained throughout the entire eight weeks of the study. In addition, Symbyax patients had no statistically greater risk of treatment-emergent mania than patients taking placebo.

Your Medical History
If you are considering this medication, be sure to discuss your medical history with your health care provider before starting Symbyax. Be sure to tell your doctor if:

  • You are currently taking any medications
  • You are taking Prozac (fluoxetine) or Zyprexa (olanzapine)
  • You are taking or plan to take nonsteroidal anti-inflammatory drugs or aspirin
  • You are pregnant or plan to become pregnant
  • You are breast-feeding or plan to breast-feed
  • You are older than 65 and have dementia
  • You have high blood sugar, diabetes or a family history of diabetes
  • You have liver problems
  • You have seizures
  • You have high or low blood pressure
  • You have heart problems
  • You have had a stroke
  • You have an enlarged prostate
  • You have an eye problem called narrow angle glaucoma
  • You have a stomach problem called paralytic ileus
  • You currently smoke
  • You drink alcohol
  • You exercise a lot

Do not take Symbyax if:

  • You are taking a monoamine oxidase inhibitor (MAOI)
  • You are taking Mellaril (thioridazine)
  • You are allergic to Prozac (fluoxetine) or Zyprexa (olanzapine)

When taking Symbyax do not:

  • Drive or operate heavy machinery until you know how it will affect you
  • Take other medications (prescription or over-the-counter) without consulting your doctor
  • Get pregnant
  • Breast-feed
  • Drink alcohol
  • Get over-heated or dehydrated
  • Take MAOIs or Mellaril within two weeks of starting Symbyax or at least five weeks after stopping Symbyax

Important Notes:

  • This medication has not been approved for the treatment of children.
  • Suicide and suicidal thoughts are serious symptoms of bipolar disorder. If these develop, please sure to tell your doctor and/or go to a hospital immediately.
  • If you begin to experience the symptoms of mania or hypomania, contact your doctor as soon as possible.
Disclaimer: This profile is not intended to be all-inclusive or to replace information provided by your doctor or with the prescription from the manufacturer.

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