Olanzapine plus fluoxetine for bipolar disorder: A systematic review and meta-analysis

Silva, Marcus Tolentino; Zimmermann, Ivan Ricardo; Galvão, Taís Freire; Pereira, Maúrício Gomes

doi:10.1016/j.jad.2012.11.001

Cited by 18 publications

(15 citation statements)

References 45 publications

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“…These results were recently confirmed in a replication study with OLZ [42] and a seven week RCT comparing OFC to lamotrigine [43]. A meta-analysis of OFC trials demonstrated superiority to both olanzapine monotherapy and placebo, but equipoise with lamotrigine [44]. As expected, significant rates of weight gain and metabolic abnormalities were reported with OLZ and OFC.…”

Section: Second-generation Antipsychotics (Sgas)supporting

confidence: 53%

Comprehensive Pharmacologic Management of Bipolar Depression

McGirr

Bond

2014

Curr Treat Options Psych

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acids I N-acetylcysteine I Ketamine Opinion Statement Although mania is the defining feature of bipolar disorder (BD), depressive episodes are more frequent, at least as impairing, and come at high individual and societal costs. Historically, BD depression (BDD) has been under-studied, but in the last 10-15 years data from numerous placebo-controlled trials of mood stabilizers, second-generation antipsychotics, and other agents have allowed for the formulation of evidence-based treatment recommendations (Table 1). Abundant evidence exists for the efficacy of lithium, lamotrigine, quetiapine, and lurasidone in treating acute BDD. Lithium, lamotrigine, and quetiapine are also robustly effective in preventing depression during maintenance treatment, while data for lurasidone is lacking. Other second generation antipsychotics besides quetiapine are of limited benefit, with the possible exception of olanzapine, particularly in combination with fluoxetine, although weight gain and other metabolic abnormalities limit its use for many patients. Antidepressants remain controversial in the treatment of BDD, and there is limited high-quality data to guide decision making. Nevertheless, the best available evidence suggests that SSRIs and bupropion, as adjuncts to mood stabilizers, are safe and effective in the treatment of acute BDD in patients with pure depression, no mixed symptoms, and no recent rapid cycling. However, they cannot be routinely recommended for maintenance therapy due to a lack of data regarding long-term efficacy and safety. Finally, a number of promising experimental agents with novel mechanisms of action deserve further study, including vigilance-promoting drugs such as modafinil and armodafinil; the dopamine agonist pramipexole; the glutathione donor N-acetylcysteine; fatty acid supplementation; and the NMDA-receptor-antagonist ketamine.

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Section: Second-generation Antipsychotics (Sgas)supporting

confidence: 53%

Comprehensive Pharmacologic Management of Bipolar Depression

McGirr

Bond

2014

Curr Treat Options Psych

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“…They can control the affinity of dopamine, block central 5-HT2A and 5-HT2C receptors to lower symptoms of depression. Moreover, olanzapine may be applied to alleviate bipolar disorder after using serotonin reuptake inhibitors, placating the sentiment of patients [ 141 ]. A combination of olanzapine and fluoxetine has shown benefits in bipolar depression [ 142 ].…”

Section: Major Findingmentioning

confidence: 99%

A Scientometrics Analysis and Visualization of Depressive Disorder

Wang

et al. 2021

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: Multiple studies on the pathomechanisms of depressive disorder and antidepressants have been reported. However, literature involving scientometric analysis of depressive disorder is sparse. Here, we use scientometric analysis and a historical review to highlight recent research on depression. We use the former to examine research on depressive disorders from 1998 to 2018. The latter is used to identify the most frequent keywords in keyword analysis, as well as explore hotspots and depression trends. Scientometric analysis uncovered field distribution, knowledge structure, research topic evolution, and topics emergence as main explorations in depressive disorder. Induction factor, comorbidity, pathogenesis, therapy and animal models of depression help illustrate occurrence, development and treatment of depressive disorder. Scientometric analysis found 231,270 research papers on depression, a 4-fold increase over the last 20 years. These findings offer a vigorous roadmap for further studies in this field.

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“…They also reported negative results for lamotrigine and aripiprazole, lithium as well as for adjunctive inositol (Cruz et al, 2010; Kemp et al, 2010; Tamayo et al, 2010; Vieta et al, 2010c; De Fruyt et al, 2011, 2012; Gao et al, 2011; Silva et al, 2013; Citrome et al, 2014; Mukai et al, 2014; Suttajit et al, 2014). Also, it was reported that patients who do not respond in the first 2 weeks of treatment are unlikely to respond eventually and would benefit from a change in treatment (Kemp et al, 2010).…”

Section: Efficacy Datamentioning

confidence: 99%

The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

Fountoulakis

Yatham

Grunze

et al. 2016

IJNPPY

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Background:The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety.Material and Methods:The PRISMA method was used in the literature search with the combination of the words ‘bipolar,’ ‘manic,’ ‘mania,’ ‘manic depression,’ and ‘manic depressive’ with ‘randomized,’ and ‘algorithms’ with ‘mania,’ ‘manic,’ ‘bipolar,’ ‘manic-depressive,’ or ‘manic depression.’ Relevant web pages and review articles were also reviewed.Results:The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice.Conclusions:A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses.

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Olanzapine plus fluoxetine for bipolar disorder: A systematic review and meta-analysis

Cited by 18 publications

References 45 publications

Comprehensive Pharmacologic Management of Bipolar Depression

Comprehensive Pharmacologic Management of Bipolar Depression

A Scientometrics Analysis and Visualization of Depressive Disorder

The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

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