Effectiveness of switching from aripiprazole to ziprasidone in patients with schizophrenia

Aripiprazole and ziprasidone are 2 antipsychotic medications that are relatively devoid of the metabolic adverse effects associated with the second-generation antipsychotics. This study aimed to evaluate the effectiveness of switching to ziprasidone in patients who had insufficient response or intolerance to aripiprazole for the treatment of schizophrenia.

Nineteen patients receiving aripiprazole treatment for schizophrenia participated in this open-label 12-week study. Outcome measures included the Positive and Negative Syndrome Scale, Social and Occupational Functioning Assessment Scale, Calgary Depression Scale for Schizophrenia, Beck Depression Inventory, and Subjective Well-being under Neuroleptics Scale. Safety measures included metabolic parameters and scales to evaluate extrapyramidal adverse effects.

After switching to ziprasidone from aripiprazole, significant improvement of scores on the negative symptom subscale of the Positive and Negative Syndrome Scale, the Social and Occupational Functioning Assessment Scale, the Calgary Depression Scale for Schizophrenia, and the Beck Depression Inventory were observed at the study end point evaluation. Metabolic parameters including body weight, waist and hip circumferences, fasting blood glucose, and alanine aminotransferase showed statistically significant decreases. However, serum prolactin levels were significantly increased, and sedation was the most common adverse event.

Switching to ziprasidone in patients with schizophrenia who showed insufficient response or intolerance to aripiprazole improved depression, negative symptoms, and metabolic disturbances. However, sedation and hyperprolactinemia were commonly associated with the switch to ziprasidone.