Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials

Shuxin Luan,1 Hongquan Wan,1 Shijun Wang,1 He Li,2 Baogang Zhang3 1Department of Mental Health, 2Department of Pain Medicine, The First Hospital of Jilin University, 3Department of Endoscopy, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China Background...

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Autores principales:	Luan S, Wan H, Wang S, Li H, Zhang B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	treatment-resistant depression olanzapine fluoxetine meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/71c5562f3ec648a5a2a3535bbee46ab2
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spelling	oai:doaj.org-article:71c5562f3ec648a5a2a3535bbee46ab22021-12-02T04:36:18ZEfficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials1178-2021https://doaj.org/article/71c5562f3ec648a5a2a3535bbee46ab22017-02-01T00:00:00Zhttps://www.dovepress.com/efficacy-and-safety-of-olanzapinefluoxetine-combination-in-the-treatme-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Shuxin Luan,1 Hongquan Wan,1 Shijun Wang,1 He Li,2 Baogang Zhang3 1Department of Mental Health, 2Department of Pain Medicine, The First Hospital of Jilin University, 3Department of Endoscopy, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China Background: Whether olanzapine/fluoxetine combination (OFC) is superior to olanzapine or fluoxetine monotherapy in patients with treatment-resistant depression (TRD) remains controversial. Thus, we conducted this meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of OFC with olanzapine or fluoxetine monotherapy for patients with TRD. Materials and methods: RCTs published in PubMed, Embase, Web of Science, and the ClinicalTrials.gov registry were systematically reviewed to assess the efficacy and safety of OFC. Outcomes included mean changes from baseline in Montgomery–Asberg Depression Rating Scale (MADRS), Clinical Global Impression-Severity (CGI-S), Hamilton Rating Scale for Anxiety (HAM-A), Brief Psychiatric Rating Scale (BPRS) scores, response rate, remission rate, and adverse events. Results were expressed with weighted mean difference (WMD) with 95% confidence intervals (CIs) and risk ratio (RR) with 95% CIs. Results: A total of five RCTs with 3,020 patients met the inclusion criteria and were included in this meta-analysis. Compared with olanzapine or fluoxetine monotherapy, OFC was associated with greater changes from baseline in MADRS (WMD =-3.37, 95% CI: -4.76, -1.99; P<0.001), HAM-A (WMD =-1.82, 95% CI: -2.25, -1.40; P<0.001), CGI-S (WMD =-0.37, 95% CI: -0.45, -0.28; P<0.001), and BPRS scores (WMD =-1.46, 95% CI: -2.16, -0.76; P<0.001). Moreover, OFC had significantly higher response rate (RR =1.35, 95% CI: 1.12, 1.63; P=0.001) and remission rate (RR =1.71, 95% CI: 1.31, 2.23; P<0.001). The incidence of treatment-related adverse events was similar between the OFC and monotherapy groups (RR =1.01, 95% CI: 0.94, 1.08; P=0.834). Conclusion: OFC is more effective than olanzapine or fluoxetine monotherapy in the treatment of patients with TRD. Our results provided supporting evidence for the use of OFC in TRD. However, considering the limitations in this study, more large-scale, well-designed RCTs are needed to confirm these findings. Keywords: treatment-resistant depression, olanzapine, fluoxetine, meta-analysisLuan SWan HWang SLi HZhang BDove Medical Pressarticletreatment-resistant depressionolanzapinefluoxetinemeta-analysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 609-620 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	treatment-resistant depression olanzapine fluoxetine meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	treatment-resistant depression olanzapine fluoxetine meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Luan S Wan H Wang S Li H Zhang B Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
description	Shuxin Luan,1 Hongquan Wan,1 Shijun Wang,1 He Li,2 Baogang Zhang3 1Department of Mental Health, 2Department of Pain Medicine, The First Hospital of Jilin University, 3Department of Endoscopy, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China Background: Whether olanzapine/fluoxetine combination (OFC) is superior to olanzapine or fluoxetine monotherapy in patients with treatment-resistant depression (TRD) remains controversial. Thus, we conducted this meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of OFC with olanzapine or fluoxetine monotherapy for patients with TRD. Materials and methods: RCTs published in PubMed, Embase, Web of Science, and the ClinicalTrials.gov registry were systematically reviewed to assess the efficacy and safety of OFC. Outcomes included mean changes from baseline in Montgomery–Asberg Depression Rating Scale (MADRS), Clinical Global Impression-Severity (CGI-S), Hamilton Rating Scale for Anxiety (HAM-A), Brief Psychiatric Rating Scale (BPRS) scores, response rate, remission rate, and adverse events. Results were expressed with weighted mean difference (WMD) with 95% confidence intervals (CIs) and risk ratio (RR) with 95% CIs. Results: A total of five RCTs with 3,020 patients met the inclusion criteria and were included in this meta-analysis. Compared with olanzapine or fluoxetine monotherapy, OFC was associated with greater changes from baseline in MADRS (WMD =-3.37, 95% CI: -4.76, -1.99; P<0.001), HAM-A (WMD =-1.82, 95% CI: -2.25, -1.40; P<0.001), CGI-S (WMD =-0.37, 95% CI: -0.45, -0.28; P<0.001), and BPRS scores (WMD =-1.46, 95% CI: -2.16, -0.76; P<0.001). Moreover, OFC had significantly higher response rate (RR =1.35, 95% CI: 1.12, 1.63; P=0.001) and remission rate (RR =1.71, 95% CI: 1.31, 2.23; P<0.001). The incidence of treatment-related adverse events was similar between the OFC and monotherapy groups (RR =1.01, 95% CI: 0.94, 1.08; P=0.834). Conclusion: OFC is more effective than olanzapine or fluoxetine monotherapy in the treatment of patients with TRD. Our results provided supporting evidence for the use of OFC in TRD. However, considering the limitations in this study, more large-scale, well-designed RCTs are needed to confirm these findings. Keywords: treatment-resistant depression, olanzapine, fluoxetine, meta-analysis
format	article
author	Luan S Wan H Wang S Li H Zhang B
author_facet	Luan S Wan H Wang S Li H Zhang B
author_sort	Luan S
title	Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
title_short	Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
title_full	Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
title_fullStr	Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
title_full_unstemmed	Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
title_sort	efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/71c5562f3ec648a5a2a3535bbee46ab2
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Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials

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