Weight gain ziprasidone

Weight gain. Ziprasidone is associated with less weight gain than are other atypical antipsychotic agents. 

Quetiapine (Seroquel). Another atypical antipsychotic, quetiapine has also been approved by the FDA for the treatment of acute mania. It is usually administered twice daily at doses of 150-750mg/day. Like its counterparts, quetiapine is a well-tolerated medication. Its common side effects are drowsiness, dizziness, and headache. It causes less weight gain than olanzapine or clozapine but more than ziprasidone or aripiprazole. Quetiapine also does not cause agranulocytosis nor does it increase the risk of seizures. It can occasionally cause mild changes in liver function tests, but these usually return to normal even if the patient continues taking quetiapine. 

Ziprasidone. To date, no publications have appeared on the use of ziprasidone in autistic disorder and other PDDS. The drug was recently released in the United States and is reported to be associated with less weight gain than the other available atypical antipsy-chotics. 

Atypical antipsychotics cause fewer EPS than do conventional antipsychotics. Clozapine and quetiapine are the least likely to cause EPS and are therefore recommended for treatment of psychosis in patients with Parkinson s disease. With the notable exception of risperidone, atypical antipsychotics cause substantially less hyperprolactinemia than do conventional antipsychotics. Weight gain is a side effect of all atypical antipsychotics except ziprasidone and aripiprazole. Concerns about cardiac conduction delay with ziprasidone therapy exist and warrant consideration in patients who have... 

When particularly problematic, one may consider switching to molindone or ziprasidone, both of which may not cause weight gain. 

Dihydroindolone Ziprasidone Perhaps less weight gain than clozapine, parenteral form available QTC prolongation... 

Aripiprazole Blockade of 5HT2A receptors > blockade of D2 receptors Some a blockade (clozapine, risperidone, ziprasidone) and M-receptor blockade (clozapine, olanzapine) variable receptor blockade (all) Schizophrenia—improve both positive and negative symptoms bipolar disorder (olanzapine or risperidone adjunctive with lithium) agitation in Alzheimer s and Parkinson s (low doses) major depression (aripiprazole) Toxicity Agranulocytosis (clozapine), diabetes (clozapine, olanzapine), hypercholesterolemia (clozapine, olanzapine), hyperprolactinemia (risperidone), QT prolongation (ziprasidone), weight gain (clozapine, olanzapine)... 

There has been one comprehensive meta-analysis including over 80 studies and over 30 000 patients (814). A meta-analysis of trials of neuroleptic drugs showed the following mean weight gains in kg after 10 weeks of treatment clozapine, 4.5 olanzapine, 4.2 thioridazine, 3.2 sertindole, 2.9 chlorpromazine, 2.6 risperidone, 2.1 haloperidol, 1.1 fluphenazine, 0.43 ziprasidone 0.04 molindone, —0.39 placebo, —0.74... 

A 12-year-old boy had significant weight gain within 3 months of starting to take ziprasidone, from 63 kg (BMI = 26.5) before treatment to 69 kg (BMI = 28.2) after treatment (1212). 

Jaworowski S, Hauser S, Mergui J, Hirsch H. Ziprasidone and weight gain. Clin Neuropharmacol 2004 27 99-100. 

Patients taking olanzapine (mean dose 12.6 mg/day n = 71) had significantly more weight gain than those taking ziprasidone (mean dose 135.2 mg/day n = 55) in a 6-month, randomized, double-blind, multicenter study of 126 patients (63c). The mean changes in body weight and body mass index were 5.0 kg and 1.3 kg/m2 respectively with olanzapine and -0.8 kg and -0.6 kg/m2 with ziprasidone. 

Ziprasidone is apparently well tolerated, with a limited potential to cause extrapyramidal adverse effects or weight gain (4). Out-patients who partly respond to conventional antipsychotic drugs, risperidone, or olanzapine may have improved control of psychotic symptoms after switching to ziprasidone, according to the results of a reanalysis of 6-week, multicenter, randomized, open, parallel-group studies in patients with schizophrenia who had previously taken conventional antipsychotic drugs (n = 108), olanzapine (n = 104), or risperidone (n = 58) these results have been published in two different journals (5, 6). 

Mechanism of any possible weight gain is unknown weight gain is not common with ziprasidone and may thus have a different mechanism from atypical antipsychotics for which weight gain is common or problematic... 

---