Intramuscular Ziprasidone, 2 mg Versus 10 mg, in the Short-Term Management of Agitated Psychotic Patients
J Clin Psychiatry 2001;62(1):12-18
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: There is a clear need
for effective, well-tolerated intramuscular (i.m.) agents for the acute
control of agitated psychotic patients. Currently used agents, including
conventional antipsychotics and/or benzodiazepines, may be associated
with distressing side effects such as extrapyramidal side effects and
Objective: The objective of this study was to
evaluate the efficacy and tolerability of the rapid-acting i.m.
formulation of the novel antipsychotic ziprasidone in the
treatment of inpatients with psychosis and acute agitation
Method: In a 24-hour, double-blind, fixed-dose
clinical trial, patients were randomly assigned to receive up to
4 injections (every 2 hours p.r.n.) of 2 mg (N = 54) or 10 mg (N
= 63) of ziprasidone i.m. The Behavioral Activity Rating Scale
measured behavioral symptoms at baseline and the response to
treatment up to 4 hours after the first i.m. injection.
Results: Ziprasidone i.m., 10 mg, rapidly
reduced symptoms of acute agitation and was significantly more
effective (p < .01) than the 2-mg dose up to 4 hours after the
first injection. Patients were calmed but not excessively
sedated, and over half were classed as responders 2 hours after
the 10-mg dose. No acute dystonia or behavioral disinhibition was
reported. One patient who received the 10-mg dose experienced the
extrapyramidal side effect akathisia.
Conclusion: Ziprasidone i.m., 10 mg, is rapidly
effective and well tolerated in the short-term management of the
agitated psychotic patient. Comparison with a study of identical
design comparing 2-mg with 20-mg doses in patients with similar
levels of psychopathology suggests that efficacy with 10 mg or 20
mg of ziprasidone i.m. is significant and dose related.