Symbyax Overview and FAQ
Symbyax (olanzipine/fluoxetine) is a prescription medication for adults who have depression with bipolar disorder. This is a mental health condition that causes extreme mood swings. Eli Lilly and Company manufactures Symbyax. The U.S. Food and Drug Administration (FDA) approved the medication in 2003.
In March 2009, the FDA approved Symbyax to treat depression. The original FDA approval was only for bipolar depression. It took Eli Lilly several attempts to secure approval for Symbyax to treat treatment-resistant depression.
Here, we'll discuss the uses and side effects of Symbyax. We'll also explain what to do if you or a loved one become sick after taking this medication.
What Is Symbyax?
Symbyax contains olanzapine (Zyprexa) and fluoxetine (Prozac). Olanzapine is an atypical antipsychotic medicine. It treats symptoms of schizophrenia such as hearing voices, seeing things that aren't there, mistaken beliefs, etc.
Fluoxetine, or Prozac, is an antidepressant drug that also treats panic disorder and obsessive-compulsive disorder (OCD). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that helps regulate mood.
Doctors also prescribe Symbyax for off-label uses such as:
- Eating disorders
- Post-traumatic stress disorder (PTSD)
Talk to Your Healthcare Professional Before Taking Symbyax
Before you start taking Symbyax, talk to your healthcare professional. They need to know if you're taking other medications, including over-the-counter ones. You must also tell them if you are suffering from any medical conditions.
Specifically, tell your doctor if you currently have or have suffered from any of the following:
- Heart problems
- Liver disease
- High blood pressure
- Trouble breathing
Let your doctor know if you are taking any of the following:
- Linezolid (Zyvox)
- Any other SNRIs
- Alcohol or recreational drugs
- NSAIDs like ibuprofen or naproxen
- St. John's Wort
- Citalopram (Celexa)
- Flecainide (Tambocor)
You should also tell your doctor if you are pregnant, trying to get pregnant, or breastfeeding. Your healthcare provider will ensure there's no risk of adverse drug interactions between these medications and Symbyax.
Who Should Not Take Symbyax?
You should not take Symbyax if you take other antidepressants, such as a monoamine oxidase inhibitor (MAOI), or if you have stopped taking an MAOI in the last 14 days. Taking these two drugs close in time can cause severe reactions, including the following:
- High body temperature
In rare cases, this reaction can cause a risk of death in patients. Never take Symbyax if you are taking Mellaril (thioridazine), a drug used to treat schizophrenia. Taking Symbyax and Mellaril together can cause serious heartbeat problems.
Symbyax Side Effects
Almost every drug has side effects. Most are minor. Unfortunately, bipolar depression patients may also experience severe side effects while taking Symbyax.
The common side effects of Symbyax are:
- Dry mouth
- Muscle stiffness
- Weight gain
Some of the serious side effects of Symbyax include:
- Low blood pressure
- Dizziness or fainting
- Blurred vision
- Increased heartbeat
- Liver problems
- Difficulty swallowing
If you notice any severe side effects while taking this medication, seek immediate medical attention. This also applies if you experience an allergic reaction while taking Symbyax.
Serious Health Risks of Symbyax
Aside from the above side effects, there are also health risks from taking Symbyax. Over the years, the FDA has issued alerts as to these dangers.
Some of the health risks of Symbyax include:
- An increased risk of suicidal thoughts or actions
- Increased chance of death in older adults
- Neuroleptic malignant syndrome (NMS), a life-threatening nervous system problem
- Tardive dyskinesia (TD)
- High blood sugar and diabetes
- Strokes in older adults with dementia
- Bleeding problems
- Low salt levels
- Sexual problems
Before you take any prescription drug, read the medication guide. Drug manufacturers must include warnings of these health risks in their packaging.
Symbyax and Serotonin Syndrome
Another serious health risk of Symbyax is serotonin syndrome. In July 2006, the FDA issued an alert to doctors and the public about selective serotonin reuptake inhibitors (SSRIs), a life-threatening condition.
This condition occurs when you take Symbyax and migraine medications known as 5-hydroxytryptamine receptor agonists (triptans).
Signs and symptoms of serotonin syndrome include:
- Loss of coordination
- Fast heartbeat
- Increased body temperature
- Rapid changes in blood pressure
- Overactive reflexes
Serotonin syndrome may be more likely to occur when starting or increasing the dose of an SSRI or a triptan. If you take migraine headache medicines, ask your doctor if your medicine is a triptan.
Antidepressants and Pregnant Women
In July 2006, the FDA issued a separate alert regarding Symbyax and pregnant women. A study found that using antidepressant medicines during pregnancy may cause persistent pulmonary hypertension in the newborn (PPHN).
Babies born with PPHN have abnormal blood flow through their hearts and lungs. Babies born with PPHN can become very sick and may die.
Results from the study also showed that babies born to mothers who took SSRIs 20 weeks or later into their pregnancies were six times as likely to have PPHN.
Symbyax and Increased Risk of Suicidality
In October 2004, the FDA issued a public health advisory directing all antidepressant drug manufacturers to revise their product labeling. The new labels must include boxed warnings and expanded warning statements that alert healthcare providers to an increased risk of suicidality in children, adolescents, and young adults taking these medications.
Eli Lilly and Company, the manufacturer of Symbyax, added these warnings to Symbyax's prescribing information.
Symbyax Interactions With Other Medications and Food
It's important to tell your healthcare professional about all prescription and non-prescription medicines, vitamins, and herbal supplements you take. Your healthcare professional may have to adjust your dose or watch you more closely if you take the following medications:
- Levodopa and other dopamine agonists
- Omeprazole (Prilosec)
- Blood pressure medication
- Rifampin (Rifadin)
- Carbamazepine (Tegretol)
- Fluvoxamine (Luvox)
- Clozapine (Clozaril)
- Haloperidol (Haldol)
- Phenytoin (Dilantin)
- Pimozide (Orap)
- Sumatriptan (Imitrex)
Avoid drinking alcohol while taking Symbyax. As with any medication, also avoid using recreational drugs.
What To Do if You Become Sick After Taking Symbyax
Researchers have linked Symbyax to several health risks, particularly birth injuries to children whose mothers took the drug during pregnancy. If you or your loved one become sick after taking Symbyax, seek immediate medical attention.
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