Therapeutics
Olanzapine plus fluoxetine reduce depressive symptoms faster than either drug alone in people with treatment resistant depression
Shelton RC, Williamson DJ, Corya SA, et al. Olanzapine/fluoxetine combination for treatment-resistant depression: a controlled study of SSRI and nortriptyline resistance. J Clin Psychiatry 2005;66:1289–97.[Medline]
Q Does a combination of olanzapine and fluoxetine lead to a greater reduction in symptoms in people with treatment resistant depression compared with either drug alone?
Key Words: olanzapine • fluoxetine • depression
| The first 150 words of the full text of this article appear below. |
Design:
Multicentre randomised controlled trial.
Allocation:
Unclear.
Blinding:
Double blind.
Follow up period:
Eight weeks.
Setting:
Seventy one sites in the United States and Canada; study started in August 1999.
Patients:
500 people (age 18–65 years) with treatment resistant unipolar, non-psychotic, major depression disorder (DSM-IV; Montgomery-Åsberg Depression Rating Scale (MADRS) total score 
20). Participants had not responded to a selective serotonin reuptake inhibitor in the past, and also failed to respond to nortriptyline (<30% reduction in MADRS score) during a seven week lead-in phase. Exclusions: inability to maintain adequate blood nortriptyline levels, taking medications with primary CNS activity (except lorazepam), receiving or likely to need electroconvulsive therapy, psychotic symptoms, and pregnant or lactating women.
Intervention:
Olanzapine (6–12 mg/day) plus fluoxetine (25–50 mg/day), olanzapine (6–12 mg/day) alone, fluoxetine (25–50 mg/day) alone, or nortriptyline (25–175 mg/day) alone.
Outcomes:
Mean change in MADRS score from baseline.
Patient follow up:
80.4%.
At eight weeks,
University of Melbourne, Geelong, Australia
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