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Open Access Highly Accessed Review

Evidence review and clinical guidance for the use of ziprasidone in Canada

David M Gardner1*, Andrea L Murphy1, Stan Kutcher1, Serge Beaulieu2, Carlo Carandang1, Alain Labelle3, Pierre Lalonde4, Ashok Malla2, Heather Milliken1, Claire O’Donovan1, Ayal Schaffer5, Jorge Soni5, Valerie H Taylor5 and Richard Williams6

Author Affiliations

1 Department of Psychiatry, Dalhousie University, Halifax, NS, Canada

2 Department of Psychiatry, McGill University, Montreal, QC, Canada

3 Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada

4 Centre de recherche Fernand-Seguin de l’Hôpital Louis-H. Lafontaine, Montreal, QC, Canada

5 Department of Psychiatry, University of Toronto, Toronto, ON, Canada

6 Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

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Annals of General Psychiatry 2013, 12:1  doi:10.1186/1744-859X-12-1

Published: 24 January 2013

Abstract

While indicated for schizophrenia and acute mania, ziprasidone’s evidence base and use in clinical practice extends beyond these regulatory approvals. We, an invited panel of experts led by a working group of 3, critically examined the evidence and our collective experience regarding the effectiveness, tolerability and safety of ziprasidone across its clinical uses. There was no opportunity for manufacturer input into the content of the review. As anticipated, ziprasidone was found to be effective for its indicated uses, although its utility in mania and mixed states lacked comparative data. Beyond these uses, the available data were either unimpressive or were lacking. An attractive characteristic is its neutral effect on weight thereby providing patients with a non-obesogenic long-term treatment option. Key challenges in practice include the need for dosing on a full stomach and managing its early onset adverse effect of restlessness. Addressing these issues are critical to its long-term success

Keywords:
Ziprasidone; Expert consensus; Schizophrenia; Bipolar disorder; Depression; Anxiety; Dosing; Off-label