Can A Patient Switch From Cipralex To Oleanze Plus Without Any Side Effect?

Posted on Tue, 21 May 2013

Question: hi a patient has taken 5 days of 2.5 mg Cipralex each day. Now another doctor has prescribed Oleanze plus each day. Can patient switch from Cipralex to Oleanze plus without any side effect and due to change of medication????

Answered by Dr. Sundar Gnanavel (1 hour later)

Hello.....
Thanks for your query. Cipralex is escitalopram, a SSRI group of antidepressant. Oleanz plus is a a combination of olanzapine, an antipsychotic with fluoxetine, a drug similar to escitalopram. I guess, some psychotic symptoms were detected in addition to depression that required a shift in medication. The change can be effected without any problem. However, she may show some side effects like a bit of sleepiness and weight gain. I would suggest dietary restrictions and daily exercises to counter this. Wish him/her good health.
Regads
Dr Sundar
Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sundar Gnanavel (9 hours later)

One doctor has prescribed Cipralex to begin with since he is seeing only 50:50 chance of psycho symptoms and hence first try with anti depressent only and then go for anti psychotic if patient doesnot respond to Ciprlex. whereas the other doctor sees psycho symptoms and go straight for Oleanz. What are the risk reward in both approaches and side effects. Any risks in delaying of anti psycho medicine.

Answered by Dr. Sundar Gnanavel (10 hours later)

Hello....
Diagnosis in psychiatry is a bit arbitrary since we have no investigations to aid us. If your new psychiatrist has picked up some psychotic symptoms, go with his prescription of antipsychotic-antidepressant combo. Any delay in starting antipsychotic after onset of psychosis will result in difficulties in symptom control later on. Hence, it is better to go with the new combination than only cipralex. As i said weight gain and sleepiness would be side effects. Dietary restrictions and daily exercises would address the problem. Wish him/her good health.
Regards
Dr Sundar
Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sundar Gnanavel (20 hours later)

After 6 days of Cipralex patient is feeling much better. S it a sign of non bipolar disorder. If ot is actually a bipolar disordeer is the delay in Oleanz can create problem. If so whether tretment of oleanz should start straight away or can wait depending on the result from Cipralex.

Answered by Dr. Sundar Gnanavel (53 minutes later)

Hello.....
Response to cipralex can be an indicator of either pure depression or bipolar depression. Olanzapine is also a good mood stabiliser. Hence, i would suggest that you start the same as response to cipralex does not give a definite pointer to one specific disorder.
Regards
Dr Sundar
Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar