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Probable association between ziprasidone and worsening hypertension
Noemi Villanueva1, Courtney Markham-Abedi, Connie McNeely
1Johnson & Johnson, Madrid, Madrid, Spain.
Pharmacotherapy
|September 2, 2006
Summary
Ziprasidone may worsen hypertension in some patients. This case study shows ziprasidone increasing blood pressure, suggesting careful monitoring for patients with pre-existing hypertension.
Area of Science:
- Pharmacology
- Clinical Psychiatry
- Cardiovascular Medicine
Background:
- Atypical antipsychotics like ziprasidone are used for schizophrenia.
- Hypertension is a potential concern in patients with schizophrenia.
- Premarketing studies suggest a low incidence of hypertension with ziprasidone.
Observation:
- A 53-year-old woman with hypertension and schizophrenia experienced elevated blood pressure during ziprasidone treatment.
- Her blood pressure did not increase with other atypical antipsychotics.
- Systolic blood pressure increased significantly with ziprasidone dose (0.22 mm Hg/mg/day).
Findings:
- Mean systolic blood pressure increased from 141 to 158 mm Hg during ziprasidone therapy.
- Mean diastolic blood pressure increased from 79 to 88 mm Hg.
- A 40 mg/day ziprasidone increase correlated with an 8.8 mm Hg rise in systolic blood pressure.
Implications:
- Clinicians should monitor blood pressure in hypertensive patients prescribed ziprasidone.
- Ziprasidone may exacerbate pre-existing hypertension in susceptible individuals.
- Switching to an alternative antipsychotic may be necessary if hypertension worsens.
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