Ziprasidone comparative studies

Brook S, Lucey JV, Gunn KP. Intramuscular ziprasidone compared with intramuscular haloperidol in the treatment of acute psychosis. Ziprasidone I.M. Study Group. J Clin Psychiatry 2000 61(12) 933-41. 

Psychiatric The incidence of suicide-related events in patients with schizophrenia or bipolar disorder taking aripiprazole has been studied using administrative data from three US sources [65 "]. Suicide attempts and death by suicide were assessed in patients aged at least 18 years. Among 20489 antipsychotic drug users (8985 patient-years), unadjusted suicide event rates per 1000 patient-years were 21 for aripiprazole 24 for olanzapine 32 for quetiapine 20 for risperidone and 49 for ziprasidone. Compared with current users of the other antipsychotic... 

Strom BL, Eng SM, Faich G, Reynolds RF, D Agostino RB, Ruskin J, Kane JM. Comparative mortality associated with ziprasidone and olanzapine in real-world use among 18,154 patients with schizophrenia the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC). Am J Psychiatry 2011 168 193-201. 

Intramuscular ziprasidone has recently been compared with intramuscular haloperidol in the treatment of acute psychosis for a very short period (66). Patients were randomly allocated to intramuscular ziprasidone for up to 3 days of flexible dosing (n = 90 last oral daily dose 91 mg) or haloperidol (n = 42 last oral daily dose 14 mg) followed by oral treatment to day 7. Mean reductions from baseline in all efficacy variables were significantly greater with ziprasidone than with haloperidol at the end of the study. The percentage of patients who had any adverse event was lower with ziprasidone (46%) than with haloperidol (60%) most of the adverse effects were mild or moderate. Four patients discontinued ziprasidone owing to adverse events compared with one in the haloperidol group. 

Other atypical antipsychotics commonly prescribed for treatment of autism include olanzapine, quetiapine, ziprasidone, and clozapine (Oswald and Sonenklar, 2007). Placebo-controlled trials of these agents in ASD populations have not been reported, with the exception of a small pilot study of olanzapine in which three of six children treated with olanzepine were rated as responders, compared to one of five in the placebo group (Hollander et al., 2006b). Open-label studies (reviewed by... 

A randomised, placebo-controlled study in 25 healthy subjects taking lithium carbonate 450 mg twice daily for 15 days, found that ziprasidone 20 mg twice daily on days 9 to 11, followed by 40 mg twice daily on days 12 to 15 caused only a small increase in the steady-state serum-lithium levels (14% compared with 11% in the placebo group). A 5% reduction in renal clearance was seen in the ziprasidone group and a 9% reduction was seen in the placebo group. These differences were neither statistically nor clinically significant. No special precautions would therefore seem to be necessary if ziprasidone is given to patients taking lithium. 

Systematic reviews Ziprasidone has been compared with other atypical antipsychotic drugs in a systematic review [151 ]. The rate of premature study discontinuation was very high (59% n=3361). Ziprasidone was less efficacious than amisulpride, olanzapine, and risperidone, but based on limited data there were no significant differences in tolerability between ziprasidone and amisulpride or clozapine. Ziprasidone produced less weight gain than olanzapine (median difference, -3.8 95% Cl = -4.7, -3.0 ... 

Metabolism A prospective, naturalistic study of 809 patients that compared 10 antipsychotics found there were no significant relationships between any of the antipsychotic drugs and increased waist circumference, HOMA-IR or LDL-cholesterol levels [54 ]. Hypertriglyceridemia was associated with clozapine, reduced HDL-cholesterol with both clozapine and olanzapine, hypertension with perphenazine, and hyperglycaemia inversely with ziprasidone and positively with haloperidol. 

Controlled studies A QTc study of three doses of ilopeiidone was conducted in the presence of metabolic inhibitors of CYP2D6 and/or CYP3A4 with a comparison to quetiapine and ziprasidone [157 ]. Uoperidone BID produced mean changes in QTcF comparable with ziprasidone and quetiapine. A higher single daily dose of Uoperidone... 

Controlled Studies A study of pooled data from nine randomised, double-blind, placebo-controlled, acute studies of ziprasidone in bipolar mood disorder and schizophrenia was conducted [279 -]. The risk of discontinuation due to adverse events or >7% weight gain was not different to placebo. The risk for akathisia was significantly higher for mood disorders and the risk of extrapyramidal symptoms and somnolence (dose dependent) was significantly higher for both mood disorders and schizophrenia compared to placebo. 

---