Symbyax: A Combination of Zyprexa and Prozac

Uses, Side Effects and Research

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Symbyax is a combination of olanzapine, the active ingredient in Zyprexa, and fluoxetine, the active ingredient in Prozac. It was the first FDA-approved medication for the depressive episodes that occur in bipolar disorder, or bipolar depression.

Uses of Symbyax

Symbyax is prescribed for the treatment of the depressive phase of bipolar disorder. Virtually all patients with this disorder experience the depressive phase commonly referred to as bipolar depression.

Patients with bipolar disorder spend an average of one-third of their lives in the depressive phase of this illness.

Symbyax can also now be prescribed for treatment-resistant depression.

Common Side Effects of Symbyax

Common side effects that may go away with time include:

  • Appetite increase
  • Weight gain
  • Dry mouth
  • Diarrhea
  • Losing or not having strength
  • Sexual difficulties, including decreased interest or inability to orgasm
  • Erectile dysfunction
  • Twitching
  • Joint swelling, redness or pain

If any of these side effects don't go away or cause problems, be sure to tell your doctor.

Potentially Serious Side Effects of Symbyax

If you have any of the following side effects, it's important to contact your doctor right away as you may need medical treatment. These potentially serious side effects include:

  • Congestion
  • Runny nose
  • Cough
  • Tingling in your hands or feet
  • Dementia
  • Delusions
  • Body aches or pain
  • Gaining weight suddenly
  • Difficulty swallowing
  • Swelling in your arms, legs, hands, feet or face
  • Difficulty breathing or speaking
  • Memory problems
  • Chest tightness
  • Vision changes
  • Irregular heartbeat
  • Dizziness

Research on Symbyax

According to a study done around the time Symbyax was approved by the FDA, Symbyax helped to treat the symptoms of bipolar depression more effectively and at a significantly faster rate than placebo.

In the eight-week studies, patients in the Symbyax group experienced significantly greater improvement in depressive symptoms compared with patients taking placebo. That robust symptom improvement was sustained throughout the entire eight weeks of the study. In addition, Symbyax patients had no statistically greater risk of treatment-emergent mania than patients taking placebo.

A more recent study that looked at a series of other studies regarding Symbyax also showed its continued effectiveness in treating and keeping the depressive episodes of bipolar disorder at bay. The only concern was that the side effects may be worse when using Symbyax than they are with other medications, particularly weight gain.

Discuss Your Medical History With Your Doctor Before Starting Symbyax

If you are considering starting Symbyax, discuss your medical history with your health care provider. Be sure to tell your doctor if any of the following apply:

  • You are currently taking any medications
  • You are taking Prozac (fluoxetine) or Zyprexa (olanzapine)
  • You are taking or plan to take nonsteroidal anti-inflammatory drugs or aspirin
  • You are pregnant or plan to become pregnant
  • You are breast-feeding or plan to breast-feed
  • You are older than 65 and have dementia
  • You have high blood sugar, diabetes or a family history of diabetes
  • You have liver problems
  • You have seizures
  • You have high or low blood pressure
  • You have heart problems
  • You have had a stroke
  • You have an enlarged prostate
  • You have an eye problem called narrow angle glaucoma
  • You have a stomach problem called paralytic ileus
  • You currently smoke
  • You drink alcohol
  • You exercise often


"Olanzapine and Fluoxetine (Oral Route)." Mayo Clinic (2016).

Silva, M.T., Zimmermann, I.R., et. al. "Olanzapine plus fluoxetine for bipolar disorder: A systematic review and meta-analysis." Journal of Affective Disorders 146 (3), 2013.

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