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			{{Short description|Antidepressant medication}}
	{{Drugbox		{{Drugbox
			| Verifiedfields = changed
⚫	| verifiedrevid = 429965880
			| Watchedfields = changed
⚫	| image = Olanzapine.svg
		⚫	| verifiedrevid = 447722434
	| width = 150px
		⚫	| type = combo
	| image2 = Fluoxetine-2D-skeletal.svg
		⚫	| image = Olanzapine and fluoxetine.svg
	| width2 = 200px
	<!--Combo data-->		<!--Combo data-->
⚫	| type = combo
	| component1 = Olanzapine		| component1 = Olanzapine
	| class1 = ]		| class1 = ]
	| component2 = Fluoxetine		| component2 = Fluoxetine
	| class2 = ]		| class2 = ]
	<!--Clinical data-->		<!--Clinical data-->
	| tradename =		| tradename = Symbyax, Cinol Forte, Olapin Forte, others
			| Drugs.com = {{Drugs.com|ppa|olanzapine-and-fluoxetine}}
	| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
			| DailyMedID = Olanzapine_and_fluoxetine
	| pregnancy_US = <!-- A / B / C / D / X -->
	| pregnancy_category =		| pregnancy_AU = C
			| pregnancy_US = C
			| pregnancy_category =
	| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->		| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
	| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->		| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->
	| legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM -->		| legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM -->
	| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->		| legal_US = Rx-only
			| legal_US_comment = <ref name="Symbyax FDA label" />
	| legal_status =		| legal_status =
	| routes_of_administration =		| routes_of_administration = ]
		⚫	| ATCvet =
			| ATC_prefix = N06
		⚫	| ATC_suffix = CA03
			| ATC_supplemental =
	<!--Identifiers-->		<!--Identifiers-->
			| KEGG_Ref = {{keggcite|changed|kegg}}
⚫	| ATCvet =
			| KEGG = D10206
	| ATC_prefix = <!-- 'none' if uncategorised -->
			| CAS_number = 250603-12-4
⚫	| ATC_suffix =
	<!--Chemical data-->
	}}		}}
	The ] combination '''olanzapine/fluoxetine''' (trade name '''Symbyax''', created by ]) is a single capsule containing the ] ] and the ] (SSRI) ]. Symbyax is primarily used to treat the depressive episodes of ] as well as ].<ref name="symbyax_pi">Symbyax Prescribing Information. Eli Lilly and Company. 2010. http://pi.lilly.com/us/symbyax-pi.pdf</ref>		'''Olanzapine/fluoxetine''' (trade name '''Symbyax''', created by ]) is a ] medication containing ] (Zyprexa), an ], and ] (Prozac), a ] (SSRI). Olanzapine/fluoxetine is primarily used to treat the depressive episodes of ]<ref>{{Cite web |title=Tratamento medicamentoso dos transtornos bipolares - Transtornos psiquiátricos |url=https://www.msdmanuals.com/pt-br/profissional/transtornos-psiqui%C3%A1tricos/transtornos-do-humor/tratamento-medicamentoso-dos-transtornos-bipolares |access-date=2022-10-02 |website=Manuais MSD edição para profissionais |language=pt-BR}}</ref> as well as ].<ref name="Symbyax FDA label">{{cite web | title=Symbyax- olanzapine and fluoxetine hydrochloride capsule | website=DailyMed | date=21 April 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6b28c424-0b7e-4b75-b090-f116b113554e | access-date=30 September 2020}}</ref><ref>{{cite journal | vauthors = Benazzi F, Berk M, Frye MA, Wang W, Barraco A, Tohen M | title = Olanzapine/fluoxetine combination for the treatment of mixed depression in bipolar I disorder: a post hoc analysis | journal = The Journal of Clinical Psychiatry | volume = 70 | issue = 10 | pages = 1424–1431 | date = October 2009 | pmid = 19906346 | doi = 10.4088/JCP.08m04772gre }}</ref>
	==Indications==		==Medical uses==
		⚫	Olanzapine/fluoxetine was approved by the U.S. ] (FDA) to treat the depressive episodes of ] in 2003.<ref name="Symbyax FDA label" /> In 2009, it was granted approval for the treatment of ].<ref>{{cite web | author = Grohol, J. | title = FDA Approves Symbyax for Treatment Resistant Depression | work = Psych Central Blog | url = http://psychcentral.com/blog/archives/2009/03/23/fda-approves-symbyax-for-treatment-resistant-depression/ | access-date = 2010-07-17 | archive-date = 2017-12-26 | archive-url = https://web.archive.org/web/20171226073909/https://psychcentral.com/blog/archives/2009/03/23/fda-approves-symbyax-for-treatment-resistant-depression/ | url-status = dead }}</ref>
		⚫	Olanzapine/fluoxetine, or other ]/] combinations, are sometimes prescribed ] for ],<ref name="pmid14700010">{{cite journal | vauthors = McIntyre R, Katzman M | title = The role of atypical antipsychotics in bipolar depression and anxiety disorders | journal = Bipolar Disorders | volume = 5 | issue = Suppl 2 | pages = 20–35 | year = 2003 | pmid = 14700010 | doi = 10.1111/j.1399-2406.2003.00061.x }}</ref> ],<ref name="pmid14521477">{{cite journal | vauthors = Pederson KJ, Roerig JL, Mitchell JE | title = Towards the pharmacotherapy of eating disorders | journal = Expert Opinion on Pharmacotherapy | volume = 4 | issue = 10 | pages = 1659–1678 | date = October 2003 | pmid = 14521477 | doi = 10.1517/14656566.4.10.1659 | s2cid = 38506292 }}</ref> ] (OCD),<ref name="pmid10937610">{{cite journal | vauthors = Koran LM, Ringold AL, Elliott MA | title = Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder | journal = The Journal of Clinical Psychiatry | volume = 61 | issue = 7 | pages = 514–517 | date = July 2000 | pmid = 10937610 | doi = 10.4088/JCP.v61n0709 }}</ref> and ] (PTSD).<ref name="pmid12359687">{{cite journal | vauthors = Stein MB, Kline NA, Matloff JL | title = Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study | journal = The American Journal of Psychiatry | volume = 159 | issue = 10 | pages = 1777–1779 | date = October 2002 | pmid = 12359687 | doi = 10.1176/appi.ajp.159.10.1777 }}</ref>
⚫	Symbyax was approved by the U.S. ] (FDA) to treat the depressive episodes of ] in 2003.<ref name="symbyax_pi" /> In 2009, it was granted approval for the treatment of ].<ref>Grohol, J. "FDA Approves Symbyax for Treatment Resistant Depression." Psych Central. http://psychcentral.com/blog/archives/2009/03/23/fda-approves-symbyax-for-treatment-resistant-depression/</ref>
		⚫	==Side effects==
⚫	Symbyax, or other ]/] combinations, are sometimes prescribed ] for ]<ref name="pmid14700010">{{cite journal |author=McIntyre R, Katzman M. |title=The role of atypical antipsychotics in bipolar depression and anxiety disorders. |journal=Bipolar Disord. |year=2003 |pmid=14700010 |volume=5 Suppl 2 |pages=20–35}}</ref>, ]<ref name="pmid14521477">{{cite journal |author=Pederson KJ, Roerig JL, Mitchell JE. |title=Towards the pharmacotherapy of eating disorders |journal=Expert Opin Pharmacother. |volume=4 |issue=10 |pages=1659–78 |year=2003 |pmid=14521477 |doi=10.1517/14656566.4.10.1659}}</ref>, ]<ref name="pmid10937610">{{cite journal |author=Koran LM, Ringold AL, Elliott MA. |title=Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder |journal=J Clin Psychiatry. |volume=61 |issue=7 |pages=514–7 |year=2000 |pmid=10937610 |doi=10.4088/JCP.v61n0709}}</ref>, and ].<ref name="pmid12359687">{{cite journal |author=Stein MB, Kline NA, Matloff JL. |title=Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study |journal=Am J Psychiatry. |volume=159 |issue=10 |pages=1777–9 |year=2003 |pmid=12359687}}</ref>
		⚫	Possible side effects of olanzapine/fluoxetine include all those of the two component drugs: ] and ]. Common side effects include suicidal thoughts, increased appetite, weight gain, ], ], ], ], ], blurred vision, and difficulty concentrating.<ref name="Symbyax FDA label" />
		⚫	Olanzapine/fluoxetine could produce a severe allergic reaction and should not be used if the patient has previously experienced an allergic reaction to either fluoxetine or olanzapine.<ref name="drugscom">{{cite web | title = Symbyax | work = Drugs.com | url = https://www.drugs.com/pdr/symbyax.html }}</ref>
	==Available dosages==
		⚫	Olanzapine is correlated with an increase in blood sugar. Patients with ], or those at risk for developing it, require careful monitoring.<ref name="drugscom" />
	Symbyax is available as a capsule. Currently, five dosage combinations are produced (measured in mg olanzapine/mg fluoxetine): 3mg/25mg, 6mg/25mg, 6mg/50mg, 12mg/25mg, 12mg/50mg.<ref name="symbyax_pi" />
		⚫	In rare cases, olanzapine/fluoxetine may cause ].<ref name="Symbyax FDA label" />
	==Synergistic effects==
	Symbyax increases ] ] due to its fluoxetine component. However, Symbyax also causes an increase in ] and ]; this increase is believed to be the result of a synergistic effect between fluoxetine and olanzapine. Preclinical trials reported a 232% increase in dopamine (compared to a 66% increase with just olanzapine or a 55% increase with just fluoxetine) and a 160% increase in norepinephrine (compared to an 89% increase with just fluoxetine or a 33% increase with just olanzapine).<ref name="mechanism_symbyax_web">"Symbyax Mechinism of Action. Lilly USA. 2010. http://www.insidesymbyax.com/Pages/symbyaxmechanismofaction.aspx</ref>
		⚫	Like other SSRIs, olanzapine/fluoxetine carries a ] stating that it could increase the risk of suicidal thoughts and behaviors in patients aged 24 and under. The warning also states that olanzapine/fluoxetine may increase the risk of death in elderly patients with ]-related ].<ref name="Symbyax FDA label" />
⚫	==Side effects==
⚫	Possible side effects of Symbyax include all those of its two component drugs: ] and ].{{citation needed}} Common side effects include increased appetite, weight gain, ], ], ], ], ], blurred vision and difficulty concentrating.<ref name="symbyax_pi" />
			== See also ==
⚫	Symbyax could produce a severe allergic reaction and should not be used if the patient has previously experienced an allergic reaction to either fluoxetine or olanzapine.<ref name="drugscom">Drugs.com http://www.drugs.com/pdr/symbyax.html</ref>
			* ]
			* ]
⚫	Olanzapine, one of Symbyax's components, is correlated with an increase in blood sugar. Patients with ], or those at risk for developing it, require careful monitoring.<ref name="drugscom" />
			* "]"
			* ]
⚫	In rare cases, Symbyax may cause ].<ref name="symbyax_pi" />
			* ]
⚫	Like other SSRIs, Symbyax carries a ] stating that it could increase the risk of suicide in patients ages 24 and under. The warning also states that Symbyax may increase the risk of death in elderly patients with ]-related ].<ref name="symbyax_pi" />
	== References ==		== References ==
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	== External links ==		== External links ==
			* {{cite web | url = https://druginfo.nlm.nih.gov/drugportal/name/fluoxetine%20hydrochloride%20mixture%20with%20olanzapine | publisher = U.S. National Library of Medicine | work = Drug Information Portal | title = Fluoxetine hydrochloride mixture with Olanzapine }}
	*
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