• 1. Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou 730000, China;2. Lanzhou University Library, Lanzhou 730000, China;
LIU Meng, Email: lium2000@163.com
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Objective   To evaluate the effectiveness and safety of both olanzapine combined with fluoxetine (combination therapy) and fluoxetine (monotherapy) for refractory depression.
Methods  According to the computer retrieval from PubMed (1966 to September 2009), Cochrane Library (Issue 3, 2009), EMbase (1974 to September 2009), SCI (1974 to September 2009), CNKI (1994 to September 2009), CBM (1978 to September 2009), CSJD (1989 to September 2009) and Wanfang Database (1997 to September 2009), and the manual retrieval from related journals and conference proceedings were conducted, to include randomized controlled trials of comparison in between olanzapine combined with fluoxetine and fluoxetine in treating refractory depression. We collected the valid data after assessing the methodology quality of included studies on the basis of Jadad scoring standard, and conducted meta-analysis with RevMan 5.0 software. Results  A total of 7 studies with 1 230 patients were included. The meta-analysis showed that, there was no significant difference between two groups about the scores of HAMA (Hamilton Anxiety Scale) at the end of the 1st week, but the olanzapine combined with fluoxetine in trial group was much better for relieving anxiety situation compared to fluoxetine in control group at the end of the 2nd, 4th, 8th and 12th week. In accordance with the scores of CGI (Clinical Global Impression Scale), there was no significant difference at the end of 2nd and 4th week after treatment, but there was a significant difference at the end of 8th and 12th week. As to the changes of MADRS (Montgomery and Asberg Depression Rating Scale), the trial group was much distinct than control group at the end of the 1st, 2nd, 4th and 8th week. In summary, the clinical effect of trial group was superior to that of control group, and there was no significant difference in adverse reactions between two groups (RR=1.10, 95%CI 0.99 to 1.23).
Conclusion  Current evidence shows that, the clinical effect and safety of olanzapine combined with fluoxetine in treating refractory depression is obviously superior to that of fluoxetine.

Citation: WANG Xiaohua,GUO Xiaodong,LIU Meng. Effectiveness and Safety of Olanzapine Combined with Fluoxetine for Refractory Depression: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(9): 1102-1109. doi: 10.7507/1672-2531.20100551 Copy

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