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Long-Term Improvement in Efficacy and Safety After Switching to Ziprasidone in Stable Outpatients with Schizophrenia

Published online by Cambridge University Press:  07 November 2014

George M. Simpson ,
Cedric J. O'Gorman ,
Antony Loebel  and
Ruoyong Yang
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Abstract

Introduction:

The long-term efficacy and tolerability of treatment with ziprasidone following a switch from prior antipsychotics was evaluated in outpatients with schizophrenia or schizoaffective disorder in three open-label, flexible-dose, 1-year extension studies.

Methods:

These studies enrolled completers of 6-week trials in which subjects were switched to ziprasidone from conventional antipsychotics, olanzapine, or risperidone. Identical study designs and the small number of patients entering the extensions supported pooling of the data.

Results:

Of 185 pooled subjects entering the extension studies, 72 completed 58 weeks of treatment. Median treatment duration was 34.6 weeks; median dose was 120 mg/day at endpoint. The intent-to-treat population showed significant improvement in Positive and Negative Syndrome Scale (PANSS) total scores (−4.3 [P≤.01]), PANSS negative scores (−2.4 [P≤.0001]), and Clinical Global Impression of severity score (−0.3 [P≤.001]). Completers showed significant improvement in mean PANSS total scores (−10.2 [P<.0001]), PANSS positive scores (−2.7 [P<.0001]), PANSS negative scores (−2.7 [P<.001]), and Clinical Global Impression of severity scores (−0.6 [P<.0001]).

Conclusion:

Ziprasidone was well tolerated, and patients demonstrated significant improvement in metabolic parameters and in all movement disorder assessments. Insomnia and somnolence were the only adverse events with an incidence >10% in pooled subjects. No subject had a corrected QT interval ≥500 msec.

Type
Original Research
Information
CNS Spectrums , Volume 13 , Issue 10 , October 2008 , pp. 898 - 905
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

1.Masand, PS, Berry, SL. Switching antipsychotic therapies. Ann Pharmacother. 2000;34:200–207.Google Scholar
2.Lieberman, JA, Stroup, TS, McEvoy, JP, et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005;353:1209–1223.Google Scholar
3.Weiden, PJ. Discontinuing and switching antipsychotic medications: understanding the CATIE schizophrenia trial. J Clin Psychiatry. 2007;68(suppl 1):12–19.Google Scholar
4.Stroup, TS, Lieberman, JA, McEvoy, JP, et al.Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry. 2006;163(4):611–622.Google Scholar
5.Joy, CB, Adams, CE, Lawrie, SM. Haloperidol versus placebo for schizophrenia. Cochrane Database Syst Rev. 2006;(4):CD003082.Google Scholar
6.Allison, DB, Mentore, JL, Heo, M, et al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–1696.CrossRefGoogle ScholarPubMed
7.Baptista, T, Kin, NM, Beaulieu, S, de Baptista, EA. Obesity and related metabolic abnormalities during antipsychotic drug administration: mechanisms, management and research perspectives. Pharmacopsychiatry. 2002;35:205–219.Google Scholar
8.Newcomer, JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs. 2005;19(suppl 1):1–93.Google Scholar
9.Casey, DE, Zorn, SH. The pharmacology of weight gain with antipsychotics. J Clin Psychiatry. 2001;62(suppl 7):4–10.Google Scholar
10.Meyer, JM, Koro, CE. The effects of antipsychotic therapy on serum lipids: a comprehensive review. Schizophr Res. 2004;70:1–17.Google Scholar
11.Henderson, DC, Cagliero, E, Copeland, PM, et al.Glucose metabolism in patients with schizophrenia treated with atypical antipsychotic agents: a frequently sampled intravenous glucose tolerance test and minimal model analysis. Arch Gen Psychiatry. 2005;62:19–28.Google Scholar
12.Montes, JM, Rodriguez, JL, Balbo, E, et al.Improvement in antipsychotic-related metabolic disturbances in patients with schizophrenia switched to ziprasidone. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31:383–388.CrossRefGoogle ScholarPubMed
13.Weiden, PJ, Newcomer, JW, Loebel, AD, Yang, R, Lebovitz, HE. Long-term changes in weight and plasma lipids during maintenance treatment with ziprasidone. Neuropsychopharmacology. 2008;33:985–994.Google Scholar
14.Weiden, PJ, Simpson, GM, Potkin, SG, O'Sullivan, RL. Effectiveness of switching to ziprasidone for stable but symptomatic outpatients with schizophrenia. J Clin Psychiatry. 2003;64:580–588.Google Scholar
15.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
16.Cooper, D, Moisan, J, Gregoire, JP. Adherence to atypical antipsychotic treatment among newly treated patients: a population-based study in schizophrenia. J Clin Psychiatry. 2007;68:818–825.CrossRefGoogle ScholarPubMed
17.Cooper, D, Moisan, J, Gaudet, M, Abdous, B, Gregoire, JP. Ambulatory use of olanzapine and risperidone: a population-based study on persistence and the use of concomitant therapy in the treatment of schizophrenia. Can J Psychiatry. 2005;50:901–908.CrossRefGoogle Scholar
18.Menzin, J, Boulanger, L, Friedman, M, Mackell, J, Lloyd, JR. Treatment adherence associated with conventional and atypical antipsychotics in a large state Medicaid program. Psychiatr Serv. 2003;54:719–723.Google Scholar
19.Mullins, CD, Obeidat, NA, Cuffel, BJ, Naradzay, J, Loebel, AD. Risk of discontinuation of atypical antipsychotic agents in the treatment of schizophrenia. Schizophr Res. 2008;98:8–15.CrossRefGoogle ScholarPubMed
20.Wang, X, Savage, R, Borisov, A, et al.Efficacy of risperidone versus olanzapine in patients with schizophrenia previously on chronic conventional antipsychotic therapy: a switch study. J Psychiatr Res. 2006;40:669–676.CrossRefGoogle ScholarPubMed
21.Casey, DE, Carson, WH, Saha, AR, et al.Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study. Psychopharmacology (Berl). 2003;166:391–399.CrossRefGoogle ScholarPubMed
22.Cook, PE, Goldberg, JO, Van Lieshout, RJ. Benefits of switching from typical to atypical antipsychotic medications: a longitudinal study in a community-based setting. Can J Psychiatry. 2002;47:870–874.Google Scholar
23.Meyer, JM, Pandina, G, Bossie, CA, Turkoz, I, Greenspan, A. Effects of switching from olanzapine to risperidone on the prevalence of the metabolic syndrome in overweight or obese patients with schizophrenia or schizoaffective disorder: analysis of a multicenter, rater-blinded, open-label study. Clin Ther. 2005;27:1930–1941.Google Scholar
24.Nemeroff, CB, Lieberman, JA, Weiden, PJ, et al.From clinical research to clinical practice: a 4-year review of ziprasidone. CNS Spectr. 2005;10:S1–S20.Google Scholar
25.Joyce, AT, Harrison, DJ, Loebel, AD, Carter, CT, Ollendorf, DA. Effect of initial ziprasidone dose on length of therapy in schizophrenia. Schizophr Res. 2006;83:285–292.CrossRefGoogle ScholarPubMed
26.Mullins, CD, Shaya, FT, Zito, JM, Obeidat, N, Naradzay, J, Harrison, DJ. Effect of initial ziprasidone dose on treatment persistence in schizophrenia. Schizophr Res. 2006;83:277–284.Google Scholar
27.Daniel, DG, Zimbroff, DL, Potkin, SG, Reeves, KR, Harrigan, EP, Lakshminarayanan, M. Ziprasidone 80 mg/day and 160 mg/day in the acute exacerbation of schizophrenia and schizoaffective disorder: a 6-week placebo-controlled trial. Ziprasidone Study Group. Neuropsychopharmacology. 1999;20:491–505.Google Scholar
28.Colton, CW, Manderscheid, RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis. 2006;3:A42.Google Scholar
29.Miller, BJ, Paschall, CB 3rd, Svendsen, DP. Mortality and medical comorbidity among patients with serious mental illness. Psychiatr Serv. 2006;57:1482–1487.CrossRefGoogle ScholarPubMed
30.National Cholesterol Education Program. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497.Google Scholar
31.Natinal Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.htm. Accessed February 4, 2008.Google Scholar