Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: A survey to assess the usage pattern of Fixed dose combination (FDC) Olanzapine + Fluoxetine in the management of Bipolar Depression in India

Bipolar disorder (BD) is a chronic and highly disabling psychiatric illness affecting about 1% of the general population worldwideⁱ. The prevalence of BPAD (Bipolar affective disorder)as per Global Burden of Disease Study GBDS in India is 0.6%.ⁱⁱ The clinical course of BD is typically characterized by alternating episodes of a depressed or elevated mood with intervals of wellbeingⁱⁱⁱ. Longitudinal studies show that the onset of BD is frequently depressive polarityivand that the long-term affective morbidity, even in treated patients, is mainly depressive^v,vi

Patients with bipolar disorder spend three times more days depressed than manic or hypomanic. Depression, therefore, represents a quite common mood state among patients with bipolar disorder. This is particularly worrisome as BD-depression significantly impacts an individual’s psychosocial functioning, with impairments in work, social and family life. Suicides, which are disproportionately high in bipolar disorder, predominantly occur in the depressive state.³ Furthermore, BD-depression is the major contributor to disability associated with the illness^vii

Olanzapine/fluoxetine is an oral once-daily fixed-dose combination of the atypical antipsychotic olanzapine and the selective serotonin reuptake inhibitor (SSRI) fluoxetine that is approved for the treatment of depressive episodes associated with bipolar disorder in adults. Combination therapy with olanzapine plus fluoxetine is effective in the treatment of patients with acute bipolar depression. The combination improves depressive symptoms and symptom severity in this patient population, with an efficacy greater than that of olanzapine alone or lamotrigine^viii

This survey has been undertaken to understand the usage pattern of FDC of Olanzapine + Fluoxetine in the management of Bipolar Depression in India.

As you will be spending some extra time to give your feedback on the questionnaire based on your clinical experience, we offer to pay you by cheque a professional fee of Rs {{$contractAmount}}, on receiving the completed Survey Questionnaire Form from you.

We trust you and we are partners in promoting effective drug therapy. In that spirit we hope you will consent to participate in this survey. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.