Effectiveness of Switching to Ziprasidone for Stable but Symptomatic Outpatients With Schizophrenia
J Clin Psychiatry 2003;64(5):580-588
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Many outpatients with schizophrenia
experience persistent symptoms or side effects on their current
antipsychotic regimen. Few studies have prospectively examined
the effects of the prior medication or switching method on the
safety and efficacy of a newly available antipsychotic. Efficacy
and tolerability of ziprasidone were evaluated in patients with
DSM-IV schizophrenia or schizoaffective disorder who were
switched from conventional or atypical antipsychotics in three
6-week, multicenter, randomized, open-label, parallel-group
Method: Stable outpatients with persistent
symptoms or troublesome side effects on (1) conventional
antipsychotic (N = 108), (2) olanzapine (N = 104), or (3)
risperidone (N = 58) therapy were switched to an open-label,
6-week, flexible-dose trial of ziprasidone (40-160 mg/day).
Patients were randomly assigned at baseline to 1 of 3 switching
schedules during the first week of ziprasidone therapy. Baseline
and outcome assessments included Positive and Negative Syndrome
Scale (PANSS) and Clinical Global Impressions of Severity (CGI-S)
Results: All 3 switching strategies were
well tolerated for all 3 patient groups. After 6 weeks on
ziprasidone therapy, significant (p < .05) improvements were
observed on all major symptom measures and almost all subscales
for all switched subgroups.
Conclusion: Switching stable but
symptomatic outpatients from their previous antipsychotic to
ziprasidone was generally well tolerated and was associated with
symptom improvements 6 weeks later. Improvements occurred in
patients recently on other first-line atypical antipsychotic, as
well as in those on conventional antipsychotic, treatment. While
limitations of switching study designs do not permit
interpretation of comparative efficacy, these studies suggest
that outpatients who partially respond to conventional
antipsychotics, risperidone, or olanzapine may experience
improved control of psychotic symptoms following a switch to