Ziprasidone: a review of its use in schizophrenia and schizoaffective disorder

Ziprasidone (Geodon, Zeldox) is an atypical antipsychotic agent with a unique neurotransmitter receptor-binding profile. The oral formulation is indicated for the treatment of adult patients with schizophrenia and the intramuscular formulation for the control of acute agitation in these patients. In adult patients with schizophrenia or schizoaffective disorder, oral ziprasidone was effective at a dosage of 40-80 mg twice daily in patients experiencing a phase of acute illness, and at a dosage of 20-80 mg twice daily in those with chronic schizophrenia or schizoaffective disorder, including those who were symptomatically stable. Ziprasidone offers the advantage over most other atypical antipsychotic agents of being available in a fast-acting intramuscular formulation for control of acute agitation, thus providing clinicians with the option to safely and effectively transition to longer-term treatment with the oral formulation. Although careful consideration should be given to the propensity for ziprasidone to cause corrected QT (QTc) interval prolongation, albeit at a relatively low incidence, the drug generally has a favourable tolerability profile of low extrapyramidal syndrome (EPS) liability, neutral bodyweight gain, and potentially low propensity for metabolic complications. Thus, ziprasidone is an effective option for the management of patients with schizophrenia or schizoaffective disorder, with the intramuscular formulation providing a useful option for the treatment of acute agitation in these patients.