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Re: Zyprexa and Serotonin ???

Posted by SLS on September 28, 2001, at 14:11:46

In reply to Re: Zyprexa and Serotonin ??? SalArmy4me, posted by SLS on September 28, 2001, at 11:50:22

> > Zyprexa works best in combination with Prozac treatment (for depressive states), and on norepinephrine as well as dopamine.
> >
> > The American Journal of Psychiatry. Volume 158(1) January 2001 pp 131-134. A Novel Augmentation Strategy for Treating Resistant Major Depression
> >
> > "With fluoxetine treatment, norepinephrine and dopamine levels increase to 188% and 143% of baseline values, respectively. However, when both fluoxetine and olanzapine are given, norepinephrine and dopamine levels increase to 269% and 349% of baseline values, respectively. This suggests a neurochemical basis for the synergistic antidepressant effect observed in the present trial. The prefrontal cortex is rich in mesocorticolimbic dopamine innervation (21-23). Coupled with the well-chronicled role of norepinephrine in mood states (24), this suggests potential targets for treating resistant depression..."
> Hi Sal.
> Do you think using Zyprexa in combination with Prozac is better than using it combination with any of the other SSRIs?
> Thanks.
> - Scott

Eli Lilly has been working towards the marketing of a preparation that contains both Prozac and Zyprexa. Beginning two or three years ago, they have been funding clinical trials to provide a basis for this.

I will be very curious to see if the other SSRIs are equipotent to Prozac in combination with Zyprexa. It might very well be that Prozac is superior.

I'm really not too crazy about the idea of manufacturing a single preparation containing both drugs. I should think it makes more sense to encourage titrating towards the optimal dosage of both drugs individually. What's so hard about taking two pills instead of one? Some people need as much as 60mg of Prozac. If you start out first with the 2-for-1 preparation, how are you going to effectively treat such a case without having to switch to the individual preparations in order to reduce the potential for producing EPS. I doubt every doctor will opt for making this switch, and will instead allow for increasing the dosage of Zyprexa along with the Prozac as they increase the dosage of the new preparation.

There is some precedence for this kind of thing, though. Triavil is a combination of Elavil (amitriptyline) and Trilafon (perphenazine).

- Scott




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