Symbyax (Olanzapine and fluoxetine) Patient Information: How Should I Take the Drug at RxList

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May 27, 2012

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Depression in the Elderly »

How does depression in the elderly differ from depression in younger adults?

Depression in later life frequently coexists with other medical illnesses and disabilities. In addition, advancing age is often accompanied by loss of social support systems due to the death of a spouse or siblings, retirement, or relocation of residence. Because of changes in an elderly person's circumstances and the fact that elderly people are expected to slow down, doctors and family may miss the signs of depression. As a result, effective treatment gets delayed. Many seniors find themselves trying to cope with symptoms that could have been easily treated.

Depression tends to last longer in elderly adults. It doubles their risk of cardiac diseases and increases their risk of death from illness. At the same time, depression reduces an elderly person's ability to rehabilitate.

Studies of nursing home patients with physical illnesses have shown that the pres...

Read the Depression in the Elderly article »

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Symbyax Patient Information including How Should I Take

What should I discuss with my healthcare provider before taking fluoxetine and olanzapine (Symbyax)?

This medication is not for use in psychotic conditions related to dementia. Olanzapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions.

Do not use fluoxetine and olanzapine if you are using any of the following drugs:

pimozide (Orap);
thioridazine (Mellaril); or
an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam).

Serious and sometimes fatal reactions can occur when these medicines are taken with fluoxetine and olanzapine. You must wait at least 14 days after stopping an MAO inhibitor before you can take fluoxetine and olanzapine. You must wait 5 weeks after stopping fluoxetine and olanzapine before you can take thioridazine (Mellaril) or an MAO inhibitor.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take this medication:

liver disease;
heart disease, high or low blood pressure, or a history of heart attack or stroke;
diabetes;
high cholesterol or triglycerides;
seizures or epilepsy;
glaucoma;
paralytic ileus (a stomach disorder);
enlarged prostate; or
a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking fluoxetine and olanzapine, do not stop taking the medication without first talking to your doctor.

Fluoxetine and olanzapine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give fluoxetine and olanzapine to anyone younger than 18 years old without the advice of a doctor.

How should I take fluoxetine and olanzapine (Symbyax)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Fluoxetine and olanzapine can be taken with or without food. Try to take the medicine at the same time each day.

It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

Olanzapine can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis while you are taking olanzapine.

Store fluoxetine and olanzapine at room temperature away from moisture and heat.

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