Posted by JohnL on July 21, 2001, at 5:13:59
Hi all,
I often speak highly of Prozac and Zyprexa at this board. One reason is because they have worked so well for me, when dozens of other drugs didn't. So right up front, I obviously have a little favorable bias. Listed below are the two clinical studies that led me to this magical combination. So it isn't just my experience, but it is also the experience of clinical studies that shows a lot of promise with these two drugs when combined.Excellent research is available at www.mentalhealth.com. Follow the prompts for Medication Research. Choose Zyprexa as the drug for research, and choose 'All Topics'. When you arrive at the page that has all the research abstracts listed, you will see a box at the top with Olanzapine listed in it. You can erase it, and then type in 'Zyprexa AND Prozac', or Zyprexa AND TDR (treatment resistant depression), or whatever it is you might be interested in. Sexual concerns? Type in 'Prozac AND sexual', 'Zyprexa AND sexual', or whatever. You can creatively research any topic you want. Make sure to capitalize the word 'AND'.
I also really like the European drug Amisulpride, and I wish to God we had it in the USA. It blows away so many other meds. Here again, research is available. Type in 'Amisulpride', or maybe 'Amisulpride AND depression', or 'Amisulpride AND dysthymia', or 'Amisulpride AND anhedonia', or whatever it is you might be curious about.
Disclaimer. Mileage varies. And just like all psychiatric drugs, even my favorites can actually make things worse for some people. You'll see that in research too.
Finding the right drug is so often a hit and miss game. So I want to increase my odds of success. Research can help identify the best odds for success. In my own opinion, my own experience, and my own research, Prozac and Zyprexa should be way up high on anyone's list of drugs to try. Not just either alone, but both combined.
But maybe you don't like Prozac or Zyprexa. Maybe you are a big fan of Effexor. That's fine. You can also research that too. You can research anything you want easily. I hope this is helpful to someone.
1: Am J Psychiatry 2001 Jan;158(1):131-4
Related Articles, Books, LinkOut
A novel augmentation strategy for treating resistant
major depression.Shelton RC, Tollefson GD, Tohen M, Stahl S, Gannon KS, Jacobs
TG, Buras WR, Bymaster FP, Zhang W, Spencer KA, Feldman
PD, Meltzer HY.Department of Psychiatry, Vanderbilt University Medical Center,
Nashville, TN 37212, USA. richard.shelton@mcmail.vanderbilt.eduOBJECTIVE: Treatment-resistant depression is a significant public health
concern; drug switching or augmentation often produce limited results.
The authors hypothesized that fluoxetine could be augmented with
olanzapine to successfully treat resistant depression. METHOD: An
8-week double-blind study was conducted with 28 patients who were
diagnosed with recurrent, nonbipolar, treatment-resistant depression
without psychotic features. Subjects were randomly assigned to one of
three groups: olanzapine plus placebo, fluoxetine plus placebo, or
olanzapine plus fluoxetine. RESULTS: Fluoxetine monotherapy produced
minimal improvement on various scales that rate severity of depression.
The benefits of olanzapine monotherapy were modest. Olanzapine plus
fluoxetine produced significantly greater improvement than either
monotherapy on one measure and significantly greater improvement than
olanzapine monotherapy on the other measures after 1 week. There were
no significant differences between treatment groups on extrapyramidal
measures nor significant adverse drug interactions. CONCLUSIONS:
Olanzapine plus fluoxetine demonstrated superior efficacy for treating
resistant depression compared to either agent alone.
1: Neuropsychopharmacology 2000 Sep;23(3):250-62
Related Articles, Books,
LinkOut
Synergistic effects of olanzapine and other
antipsychotic agents in combination with fluoxetine on
norepinephrine and dopamine release in rat prefrontal
cortex.Zhang W, Perry KW, Wong DT, Potts BD, Bao J, Tollefson GD,
Bymaster FP.Neuroscience Research Division, Lilly Research Laboratories, Lilly
Corporate Center, Indianapolis, IN 46285-0510, USA.To understand the mechanism of the clinical efficacy of olanzapine and
fluoxetine combination therapy for treatment-resistant depression (TRD),
we studied the effects of olanzapine and other antipsychotics in
combination with the selective serotonin uptake inhibitors fluoxetine or
sertraline on neurotransmitter release in rat prefrontal cortex (PFC) using
microdialysis. The combination of olanzapine and fluoxetine produced
robust, sustained increases of extracellular levels of dopamine ([DA](ex))
and norepinephrine ([NE](ex)) up to 361 +/- 28% and 272 +/- 16% of the
baseline, respectively, which were significantly greater than either drug
alone. This combination produced a slightly smaller increase of serotonin
([5-HT](ex)) than fluoxetine alone. The combination of clozapine or
risperidone with fluoxetine produced less robust and persistent increases
of [DA](ex) and [NE](ex). The combination of haloperidol or MDL
100907 with fluoxetine did not increase the monoamines more than
fluoxetine alone. Olanzapine plus sertraline combination increased only
[DA](ex). Therefore, the large, sustained increase of [DA](ex),
[NE](ex), and [5-HT](ex) in PFC after olanzapine-fluoxetine treatment
was unique and may contribute to the profound antidepressive effect of
the olanzapine and fluoxetine therapy
poster:JohnL
thread:71169
URL: http://www.dr-bob.org/babble/20010720/msgs/71169.html