Olanzapine in the treatment of bipolar depression

Bipolar depression: criteria for treatment selection, definition of refractoriness, and treatment options

“…The results of this study indicate that olanzapine monotherapy has efficacy in treating acute bipolar depression (44). Patients with bipolar 1 or 2 depression were randomized to treatment with olanzapine monotherapy (n ¼ 370), placebo monotherapy (n ¼ 377) or olanzapine and fluoxetine combination (n ¼ 86) for 8 weeks.…”

“…However, given the efficacy of olanzapine monotherapy in acute bipolar depression (44) and open reports of atypical antipsychotics in treating depressive symptoms (57), it is likely that addition of an atypical antipsychotic, in particular olanzapine, may be a useful strategy for some refractory bipolar depressed patients. To date, no double-blind trials have examined the efficacy of atypical antipsychotic add on to mood stabilizers in acute bipolar depression.…”

Olanzapine in diverse syndromal and subsyndromal exacerbations of bipolar disorders

“…We found no difference in response between subjects presenting with elevated and depressed moods, consistent with reports of olanzapine possessing both antimanic and antidepressant properties. In a very recent double blind placebo controlled study olanzapine appeared effective in bipolar depression (20). In clinical studies, olanzapine appeared to relieve anxiety and depression in both psychotic and non‐psychotic disorders.…”

Mood Disorders in Family Practice

“…67 Recent data suggest that olanzapine alone or in combination with fluoxetine has efficacy in treating bipolar depression. 68, 69 Tohen and colleagues found that olanzapine monotherapy (5-20 mg/day) significantly improved bipolar depressive symptoms (p < .001 vs. placebo; baseline to endpoint). 68 Moreover, the combination of olanzapine (6 or 12 mg/day) and fluoxetine (25 or 50 mg/day) significantly improved depressive symptoms versus both placebo (p < .001) and olanzapine monotherapy (p = .002).…”

“…68, 69 Tohen and colleagues found that olanzapine monotherapy (5-20 mg/day) significantly improved bipolar depressive symptoms (p < .001 vs. placebo; baseline to endpoint). 68 Moreover, the combination of olanzapine (6 or 12 mg/day) and fluoxetine (25 or 50 mg/day) significantly improved depressive symptoms versus both placebo (p < .001) and olanzapine monotherapy (p = .002). Patients may benefit from combination therapy with olanzapine plus fluoxetine chosen for a suspected bipolar depression while it is being differentially diagnosed.…”