Posted by med_empowered on August 17, 2005, at 16:41:45
In reply to Symbyax...........Is it only for depression?, posted by woolav on August 17, 2005, at 15:40:51
hey! Right now, Symbyax is only approved for depression--namely, depressive episodes in Bipolar Disorder, although there's pretty good evidence that atypical+antidepressant combos can be effective for treatment-resistant and/or severe cases of unipolar depression. My guess is that it was tested and approved for bipolar *depression* because there are lots of meds available to treat (hypo)mania, including Zyprexa. From what I've heard from my fellow "mentally interesting" friends, although its only approved for the depressed phase of bipolar disorder, it is being used as long-term maintenace...its really appealing to some docs since it minimizes the number of meds and takes the guess work out of dosing mood-stabilizer+anti-depressant combos. My own guess is that it will end up being used kind of like Triavil, the Elavil+perphenazine combo that hit the market in the 60s or 70s...even though Elavil by itself can cause "switching" and induce/worsen psychosis, the combo has been used for mixed-episodes, agitated depression, psychotic depression, bipolar, and schizophrenia/schizoaffective disorder. But, since Zyprexa can induce/worsen (hypo)mania in some cases when used as monotherapy (this happens with the other atypicals, and the conventional drugs when used at low doses), and Prozac has a reputation for making bipolar people much, much worse, I doubt there will be much use of it for treatment of acute mania...the protocol for controlling mania focuses mostly on sedation, behavioral control, and bringing the mood down to "normal" For that reason, antipsychotics, lithium, depakote, and benzos are all popular for acute mania, but antidepressants are mostly used in the depressed phase or in a long-term treatment combo. That said...Triavil has long been used in "agitated depression," which can often overlap with "mixed-episodes"; with the increasing recognition of mixed episodes, it wouldn't surprise me if Symbyax and future atypical+antidepressant combos were RX'd off-label for "mixed-epsidoes/dysphoric mania".
poster:med_empowered
thread:543081
URL: http://www.dr-bob.org/babble/20050816/msgs/543106.html