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zyprexa r as oral formulation for the treatment of schizophrenia 1 1 adults efficacy was established in three clinical trials in patients with schizophrenia two 6 week trials and one maintenance trial 14 1 adolescents ages 13 17 efficacy was established in one 6 week trial in patients with schizophrenia 14 1 1 1 acute treatment of manic or mixed episodes associated with bipolar i disorder and maintenance treatment of bipolar i disorder 1 2 adults efficacy was established in three clinical trials in patients with manic or mixed episodes of bipolar i disorder two 3 to 4 week trials and one maintenance trial 14 2 adolescents ages 13 17 efficacy was established in one 3 week trial in patients with manic or mixed episodes associated with bipolar i disorder 14 2 1 2 medication therapy for pediatric patients with schizophrenia or bipolar i disorder should be undertaken only after a thorough diagnostic evaluation and with careful consideration of the potential risks 1 3 adjunct to valproate or lithium in the treatment of manic or mixed episodes associated with bipolar i disorder 1 2 efficacy was established in two 6 week clinical trials in adults 14 2 as zyprexa intramuscular for the treatment of acute agitation associated with schizophrenia and bipolar i mania 1 4 efficacy was established in three 1 day trials in adults 14 3 as zyprexa and fluoxetine in combination for the treatment of depressive episodes associated with bipolar i disorder 1 5 efficacy was established with symbyax olanzapine and fluoxetine in combination in adults refer to the product label for symbyax treatment of treatment resistant depression major depressive disorder in patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode 1 6 efficacy was established with symbyax olanzapine and fluoxetine in combination in adults refer to the product label for symbyax oral zyprexa is indicated for the treatment of schizophrenia efficacy was established in three clinical trials in adult patients with schizophrenia two 6 week trials and one maintenance trial in adolescent patients with schizophrenia ages 13 17 efficacy was established in one 6 week trial see clinical studies 14 1 when deciding among the alternative treatments available for adolescents clinicians should consider the increased potential in adolescents as compared with adults for weight gain and hyperlipidemia clinicians should consider the potential long term risks when prescribing to adolescents and in many cases this may lead them to consider prescribing other drugs first in adolescents see warnings and precautions 5 5 5 6 monotherapy see clinical studies 14 2 when deciding among the alternative treatments available for adolescents clinicians should consider the increased potential in adolescents as compared with adults for weight gain and hyperlipidemia clinicians should consider the potential long term risks when prescribing to adolescents and in many cases this may lead them to consider prescribing other drugs first in adolescents see warnings and precautions 5 5 5 6 adjunctive therapy to lithium or valproate see clinical studies 14 2 pediatric schizophrenia and bipolar i disorder are serious mental disorders however diagnosis can be challenging for pediatric schizophrenia symptom profiles can be variable and for bipolar i disorder pediatric patients may have variable patterns of periodicity of manic or mixed symptoms it is recommended that medication therapy for pediatric schizophrenia and bipolar i disorder be initiated only after a thorough diagnostic evaluation has been performed and careful consideration given to the risks associated with medication treatment medication treatment for both pediatric schizophrenia and bipolar i disorder should be part of a total treatment program that often includes psychological educational and social interventions zyprexa intramuscular is indicated for the treatment of acute agitation associated with schizophrenia and bipolar i mania efficacy was demonstrated in 3 short term 24 hours of im treatment placebo controlled trials in agitated adult inpatients with schizophrenia or bipolar i disorder manic or mixed episodes see clinical studies 14 3 psychomotor agitation is defined in dsm iv as excessive motor activity associated with a feeling of inner tension patients experiencing agitation often manifest behaviors that interfere with their diagnosis and care e g threatening behaviors escalating or urgently distressing behavior or self exhausting behavior leading clinicians to the use of intramuscular antipsychotic medications to achieve immediate control of the agitation oral zyprexa and fluoxetine in combination is indicated for the treatment of depressive episodes associated with bipolar i disorder based on clinical studies in adult patients when using zyprexa and fluoxetine in combination refer to the clinical studies section of the package insert for symbyax zyprexa monotherapy is not indicated for the treatment of depressive episodes associated with bipolar i disorder oral zyprexa and fluoxetine in combination is indicated for the treatment of treatment resistant depression major depressive disorder in patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode based on clinical studies in adult patients when using zyprexa and fluoxetine in combination refer to the clinical studies section of the package insert for symbyax zyprexa monotherapy is not indicated for the treatment of treatment resistant depression
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