A systematic review of combined olanzapine-fluoxetineas therapy for bipolar depression in adult andadolescent patients
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Date
2015
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Publisher
Instituto Nacional de Neurología y Neurocirugía, Departamento de Publicaciones Científicas
Abstract
Description
Objective: this systematic review assessed the safety and efficacy of olanzapine-fluoxetine combination (OFC) fortreatment of bipolar depression, specifically in studies of 8 to 12 weeks duration in adults (primar y objective) andadolescents (secondar y objective). Materials and methods: trials were identified using MEDLINE, EMBASE, CochraneLibrar y, Web of Knowledge, LILACS, WHOLIS, NEURO, Latindex, and DIALNET (2000 – July 2014). English andSpanish free-text and MeSH terms were used. Searches were supplemented with identified trials (Clinical Trials.gov)and congress abstracts. Evidence from randomized controlled trials (RCTs), nonrandomized trials, and meta-analyseswere considered. Results: nine publications repor ting 5 RCTs (6 publications), 1 nonrandomized trial, and 2 meta-analyses were included. One RCT was conducted in adolescents and one RCT was conducted in a Latin Americanpopulation. Studies enrolled from 34 to 833 par ticipants, were conducted for 7 to 8 weeks and up to 6 months, andvaried in methodological quality and reporting. The efficacy of OFC (depression rating scales, response and remissionrates) was greater compared with olanzapine monotherapy, lamotrigine monotherapy, and placebo. OFC was welltolerated in adults and adolescents. However, there was a greater frequency of weight gain, somnolence, nausea,diarrhea, and elevated metabolic parameters in par ticipants receiving OFC versus active comparators or placebo.Conclusions: this systematic review presents findings that OFC is effective and generally well tolerated for acutetreatment of bipolar depression in adults and adolescents. Existing evidence suggests that the efficacy and safetyprofile of OFC in patients from Latin America is not different to Caucasian populations.