Ziprasidone cardiovascular

Ziprasidone, pimozide, mesoridazine, and thioridazine have been shown to prolong the QT interval, and drugs with this potential have been associated with torsade de pointes-type arrhythmias and sudden death. Perform a baseline ECG and measure serum potassium and magnesium before initiation of treatment and periodically during treatment, especially during a period of dose adjustment. Patients with QT interval over 450 msec should not receive mesoridazine or thioridazine. Avoid ziprasidone in patients with histories of significant cardiovascular illness (eg. 

Cardiovascular side effects. Ziprasidone produced a mean QTc prolongation of 21 ms at maximal blood levels achieved with typical therapeutic doses. However, in all clinical trials, the rate of QTc intervals greater than 500 ms (considered a threshold for arrhythmia risk) did not differ from the rate associated with placebo (<0.1%). The QTc effect of ziprasidone is larger than that of other atypical antipsychotics but smaller than that of thioridazine. Blood levels of ziprasidone increased about 40% when ketoconazole (a metabolic inhibitor) was coadministered, and no change in QTc duration was detected. 

No placebo-controUed trials are currently available evaluating quetiapine, ziprasidone, or aripiprazole in psychosis of dementia. An open-label study suggests possible effect and good tolerability with quetiapine. For patients who respond inadequately, have elevated cardiovascular risk, or who have unacceptable side effects... 

Cardiovascular It is unknown to what extent QT interval prolongation due to ziprasidone increases cardiovascular risk particular attention has been devoted to sudden death [SEDA-31, 95]. In an open, randomized, postmarketing study... 

Cardiovascular An 8-week, open-label switch study of 189 patients reported that ziprasidone was well tolerated 13 patients experienced QTc prolongation (mild in 12 patients) [283 ]. 

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