Efficacy and Tolerability of Ziprasidone Versus Risperidone in Patients With Acute Exacerbation of Schizophrenia or Schizoaffective Disorder

Addington, Donald; Pantelis, Christos; Dineen, Mary; Benattia, I.; Romano, Steven J.

doi:10.4088/jcp.v65n1207

Cited by 73 publications

(54 citation statements)

References 27 publications

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“…The results of both the acute and long-term treatment documented similar effi cacy and a diff erential pattern of side eff ects in both treatment arms. This is widely in concert with previous comparisons of ziprasidone and risperidone in monotherapy [2,16] , switch studies between the two antipsychotics [18,36,37] as well as one recent long-term comparison over a period of 44 weeks [1] . As for the mode of action on psychotic symptoms and mood, we assume pharmacodynamic eff ects via receptors of several neurotransmitter systems.…”

Section: Discussion ▼mentioning

confidence: 75%

Long-Term Efficacy and Tolerability of Clozapine Combined with Ziprasidone or Risperidone

et al. 2010

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Section: Discussion ▼mentioning

confidence: 75%

Long-Term Efficacy and Tolerability of Clozapine Combined with Ziprasidone or Risperidone

et al. 2010

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“…In clinical studies ziprasidone is characterized by a neutral effect on weight, favourable effects on serum lipids, and no untoward effects on glucose metabolism (Lieberman et al 2005 ;Parsons et al 2009 ;Simpson et al 2004Simpson et al , 2005. Efficacy and tolerability data from short-term (Addington et al 2004 ;Daniel et al 1999 ;Keck et al 1998 ;Simpson et al 2004) and long-term (Arato et al 2002 ;Hirsch et al 2002 ;Simpson et al 2005) trials to date indicate that ziprasidone's clinical activity is consistent with its receptor profile. In contrast haloperidol targets neurotransmission at dopamine D 2 receptors but has relatively weak effects at serotonin receptors 5-HT 2A , 5-HT 1A and 5-HT 2C , as well as at histamine H 1 and muscarinic M 1 in human brain tissue.…”

Section: Introductionmentioning

confidence: 95%

“…Movement Disorder Burden Score (MDBS) was included as a primary outcome variable (Addington et al 2004).…”

Section: Efficacy and Safety Assessmentsmentioning

confidence: 99%

Remission in schizophrenia: 196-week, double-blind treatment with ziprasidone vs. haloperidol

Potkin

Weiden

Loebel

et al. 2009

Int. J. Neuropsychopharm.

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To compare the remission rate and its time-course over 196 wk of double-blind treatment with an atypical antipsychotic, ziprasidone (80-160 mg/d given b.i.d., or 80-120 mg/d given q.d.), or a conventional antipsychotic, haloperidol (5-20 mg/d). Outcome assessments included attainment of remission (Andreasen criteria) by longitudinal analysis. Positive and Negative Syndrome Scale (PANSS) scores, Global Assessment of Functioning Scale (GAF) scores, and quality-of-life (QLS) were also assessed in the initial 40-wk study phase (n=599) and the 3-yr extension study (n=186). Discontinuation rates in the initial 40-wk core and follow-up extension studies were comparable between groups : 64 % and 65 % for the 80-160 mg/d ziprasidone group, 65 % and 58 % for the 80-120 mg/d ziprasidone group, and 60 % and 66 % for the 5-20 mg/d haloperidol group, respectively. Mean change scores from baseline to LOCF endpoint (week 40 or early termination) for PANSS negative and GAF (primary efficacy variables) were not statistically significantly different between ziprasidone and haloperidol. During the 3-yr extension study, ziprasidone-treated subjects (80-160 mg/d) were more likely to achieve remission (51 %) than haloperidol-treated (40 %) subjects (p=0.04), while there was a favourable trend associated with 80-120 mg/d ziprasidone (48 %). Compared to the haloperidol group, subjects assigned to the 80-160 mg/d ziprasidone group showed a gradual and persistent improvement in remission (p=0.006) and quality-of-life (p=0.004) in the longitudinal analyses. Significant differences in the trajectory of PANSS total and GAF scores favouring the 80-160 mg/d ziprasidone group were also observed. In this long-term, double-blind study, ziprasidone treatment was more likely to result in remission than haloperidol treatment, and was associated with greater improvement in quality-of-life.

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“…The study was conducted in Australia, Canada, Ireland, Poland, New Zealand, and the United Kingdom between August 1, 1995, and December 19, 1997. Patients who had responded to treatment (in the opinion of the investigator) in the 8-week core study comparing ziprasidone and risperidone 14 were eligible to enter a 44-week extension involving the same double-blind treatment regimen. Eligible females must have been either of nonchildbearing potential or practicing successful contraception for at least 3 months prior to study entry.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

A Comparison of Ziprasidone and Risperidone in the Long-Term Treatment of Schizophrenia: A 44-Week, Double-Blind, Continuation Study

et al. 2009

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W La Revue canadienne de psychiatrie, vol 54, no 1, janvier 2009 46Objective: This randomized, double-blind, multicentre extension study compared the efficacy, tolerability, and safety of ziprasidone and risperidone for schizophrenia or schizoaffective disorder. Methods:Patients who had responded to treatment for an acute exacerbation of illness in an 8-week study received ziprasidone, 80 to 160 mg/day (n = 62), or risperidone, 6 to 10 mg/day (n = 77), for up to 44 additional weeks. Primary efficacy variables included changes in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impression Severity (CGI-S) score. Tolerability and safety assessments included movement disorders, adverse events, study discontinuation rates, and weight and metabolic parameters.Results: Both the ziprasidone and risperidone groups showed statistical improvement from baseline in PANSS and CGI-S scores at study end point with no significant differences between treatment groups. More risperidone-treated patients completed the study (41.6%) than ziprasidone-treated patients (33.9%), but the difference was not statistically significant. Ziprasidone-treated patients who completed the study showed greater improvement in depressive symptoms assessed by Montgomery and Asberg Depression Rating Scale than risperidone-treated patients (P < 0.05). Ziprasidone was associated with a more favourable effect on extrapyramidal symptom (EPS) measures and prolactin as well as less weight gain than risperidone. Median dosages were ziprasidone 120 mg/day and risperidone 8 mg/day. Conclusions:Ziprasidone and risperidone demonstrated similar efficacy during long-term treatment of patients with schizophrenia or schizoaffective disorder. While more subjects on risperidone completed the extension study, ziprasidone was associated with fewer adverse effects on weight, EPS measures, and prolactin than risperidone.Can J Psychiatry. 2009;54(1):46-54. Clinical Implications· Both ziprasidone and risperidone were effective as continuation and maintenance treatment in patients recovering from acute exacerbations of schizophrenia or schizoaffective disorder. · Risperidone had greater adverse effects on weight gain, EPS measures, and prolactin than ziprasidone. · Ziprasidone may be associated with beneficial effects on depressive symptoms associated with schizophrenia in patients undergoing long-term treatment, based on a post hoc analysis. Limitations· Study dosages diverged somewhat from current clinical practice. The mean ziprasidone dosage was lower than that generally associated with maximum efficacy; risperidone dosage was higher than currently thought optimal in the treatment of schizophrenia. · The patient sample involved people who had responded to treatment (based on investigator judgment) for an acute exacerbation of illness. It is not known whether these results can be fully generalized to unselected patients with schizophrenia. · The number of subjects in the study may not have been large enough to document statistically significant ...

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Efficacy and Tolerability of Ziprasidone Versus Risperidone in Patients With Acute Exacerbation of Schizophrenia or Schizoaffective Disorder

Cited by 73 publications

References 27 publications

Long-Term Efficacy and Tolerability of Clozapine Combined with Ziprasidone or Risperidone

Long-Term Efficacy and Tolerability of Clozapine Combined with Ziprasidone or Risperidone

Remission in schizophrenia: 196-week, double-blind treatment with ziprasidone vs. haloperidol

A Comparison of Ziprasidone and Risperidone in the Long-Term Treatment of Schizophrenia: A 44-Week, Double-Blind, Continuation Study

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