Ziprasidone is an atypical or second generation antipsychotic neuroleptic, prescribed for the treatment of schizophrenia and bipolar disorder. It is a dopaminergic and serotonergic antagonist. It is effective on persistent positive and positive symptoms of schizophrenia (although it has not been compared with clozapine, which is, to date, the antipsychotic that offers the best results against schizophrenia).
Among its side effects are drowsiness, nausea, headache and lengthening of the QT cardiac interval. It causes fewer extrapyramidal symptoms than haloperidol, but a higher rate of metabolic effects.
Other side effects are: asthenia, agitation, akathisia, dizziness, dystonia, hypertonia, tremor and visual disturbances.
Overdose can cause sedation, speech disturbance, hypertension. There is no specific antidote for an overdose, and it requires monitoring and supportive treatment.
Ziprasidone is contraindicated if the patient is allergic. Ziprasidone is contraindicated in patients with prolonged, congenital or acquired QT cardiac interval, and in patients who have suffered acute recent myocardial infarction.
Ziprasidone is contraindicated in patients with decompensated congestive heart failure or with arrhythmias treated with class IA or III antiarrhythmics. Avoid concomitant use with drugs that prolong cardiac QT interval (class IA or III antiarrhythmics, cisapride, arsenic trioxide, halofantrine, mefloquine, thioridazine, mesoridazine, pimozide, sertindole, levomethadyl acetate, sparfloxacin, gatifloxacin, moxifloxacin, mesylate, dolasetron).
Ziprasidone can moderately inhibit the cytochromes CYP2D6 and CYP3A4, take into account if the patient is taking drugs metabolized by these cytochromes.
Joint use with drugs that prolong the QT cardiac interval should be avoided.
Caution in the use of ziprasidone together with centrally acting drugs. Avoid drinking alcohol.
Ketoconazole may increase the concentration of ziprasidone and carbamazepine may decrease it.
Risk of pharmacodynamic interactions (arrhythmia) if taken together with lithium.
Oral exposure of ziprasidone may be diminished by carbamazepine.
There is a risk of serotoninergic syndrome if taken concomitantly with SSRI antidepressants.
- Zeldox ®
Gene or region studied