Side Effects of ziprasidone injection: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main research findings

Ziprasidone is a newer type of antipsychotic medication used to treat schizophrenia and bipolar disorder. Ziprasidone is known to have fewer side effects such as weight gain and metabolic abnormalities compared to conventional antipsychotics. However, ziprasidone, like other antipsychotics, has been reported to have some side effects.

When administered orally, ziprasidone should be taken with food. If taken without food, ziprasidone absorption is reduced and the effectiveness of the drug may be compromised. Ziprasidone can also disrupt the electrical activity of the heart, leading to QT prolongation. QT prolongation can lead to cardiac arrhythmias, which can be life-threatening. Therefore, if you are taking ziprasidone, you should consult your doctor about any history of heart disease or drug interactions. 15

Reasons for side effects

Side effects of ziprasidone are thought to be related to the drug's mechanism of action. Ziprasidone acts on dopamine and serotonin receptors in the brain. These receptors are thought to work to improve mental symptoms. However, these receptors can also cause side effects. For example, acting on dopamine receptors can cause digestive side effects such as nausea, vomiting, and constipation. Acting on serotonin receptors can cause side effects such as drowsiness, fatigue, and dizziness.

Common side effects

Drowsiness

Ziprasidone can cause drowsiness. 15

QT prolongation

Ziprasidone can disrupt the electrical activity of the heart, leading to QT prolongation. 15

Acute Dystonia

Conventional intramuscular (IM) antipsychotics used in managing acute exacerbation of schizophrenia are associated with side effects such as acute dystonia. 11

Hypotension and Extrapyramidal Side Effects (EPS)

For short-term intramuscular preparations the main risk with classical compounds are hypotension and extrapyramidal side effects (EPS). 12

Lithium intoxication

Lithium intoxication in the two presented cases was associated with the fast increase of ziprasidone serum level after its parenteral application, possibly affecting lithium excretion and thereby leading to lithium intoxication. 8

Side effect management

Drowsiness

If you experience severe drowsiness, consult your doctor. You may need to adjust the dose of the drug or take other medications.

QT prolongation

If you are at risk for QT prolongation, consult your doctor. You should consult your doctor about any history of heart disease or drug interactions.

Comparison between studies

Commonalities among studies

Many studies have shown that ziprasidone is effective in treating schizophrenia and bipolar disorder. Ziprasidone has also been shown to have fewer side effects such as weight gain and metabolic abnormalities compared to conventional antipsychotics.

Differences among studies

Different studies have reported different results regarding the side effects of ziprasidone. For example, one study reported that ziprasidone may be more likely to cause QT prolongation, while another study reported that the risk of QT prolongation is not that high. This is thought to be due to differences in study methods and participant characteristics.

Precautions for applying to real life

When taking ziprasidone, please follow your doctor's instructions. Be especially careful to take the drug with food, and to consult your doctor about any history of heart disease or drug interactions.

Limitations of current research

Research on the side effects of ziprasidone is still not extensive. In particular, more research is needed on the side effects of long-term ziprasidone administration.

Directions for future research

Large-scale clinical trials are needed to further investigate the side effects of ziprasidone. Long-term follow-up studies are also needed to investigate the long-term side effects of ziprasidone.

Conclusion

Ziprasidone is an effective drug for treating schizophrenia and bipolar disorder, but there is a possibility of some side effects. When taking ziprasidone, please follow your doctor's instructions and carefully monitor for side effects. If you are concerned about side effects, consult your doctor.

Literature analysis of 26 papers
Positive Content
24
Neutral Content
1
Negative Content
1
Article Type
4
1
1
11
26
1.

Intramuscular olanzapine for agitated patients: A systematic review and meta-analysis of randomized controlled trials.

Author: KishiTaro, MatsunagaShinji, IwataNakao

Effective for agitated patients
Fewer side effects than haloperidol
Superior to placebo
Akathisia
Extrapyramidal symptoms
Over sedation

This updated systematic review and meta-analysis compared intramuscular olanzapine (OLA-IM) with placebo and other antipsychotics for the treatment of agitation in patients. OLA-IM was superior to placebo and showed comparable efficacy to haloperidol (HAL-IM) with fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

The comparative efficacy of intramuscular antipsychotics for the management of acute agitation.

Author: BosanacPeter, HollanderYitzchak, CastleDavid

Effective for agitation
Extrapyramidal side-effects

The comparative efficacy of the rapidly-acting IM atypical antipsychotics (olanzapine, ziprasidone and aripiprazole) is similar to that of the typical antipsychotic, haloperidol. IM olanzapine and ziprasidone were associated with fewer extrapyramidal side-effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Rapid tranquilization for agitated patients in emergency psychiatric rooms: a randomized trial of olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone.

Author: BaldaçaraLeonardo, SanchesMarsal, CordeiroDaniel Cruz, JackoswskiAndrea Parolin

Aggression control
Agitation control
Side effects

Olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam, and haloperidol were effective in controlling agitation and aggression caused by mental illness over 12 hours. Haloperidol plus midazolam was associated with the worst results in all the observed parameters.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Two models for weight gain and hyperphagia as side effects of atypical antipsychotics in male rats: validation with olanzapine and ziprasidone.

Author: ShoboMiwako, YamadaHiroshi, MiharaTakuma, KondoYuji, IrieMegumi, HaradaKatsuya, NiKeni, MatsuokaNobuya, KayamaYukihiko

Obesity
Weight gain

Chronic olanzapine treatment induced weight gain and hyperphagia in male rats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

A naturalistic evaluation of intramuscular ziprasidone versus intramuscular olanzapine for the management of acute agitation and aggression in children and adolescents.

Author: KhanShamima S, MicanLisa M

Effective for aggression

Intramuscular ziprasidone and intramuscular olanzapine may be equally effective in treating aggression in youth.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Intramuscular ziprasidone treatment of acute psychotic agitation in elderly patients with schizophrenia.

Author: BarakYoram, MazehDoron, PlopskiIgor, BaruchYehuda

Acute psychosis treatment

Intramuscular ziprasidone treatment has been shown to be effective and well tolerated in reducing the symptoms of acute psychosis in adults. Further research is needed to evaluate its safety in elderly patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Lithium intoxication associated with intramuscular ziprasidone in schizoaffective patients.

Author: MiodownikChanoch, HausmannMichael, FrolovaKatherina, LernerVladimir

Mood disorder treatment
Lithium intoxication

This report describes two schizoaffective patients who developed lithium intoxication after intramuscular ziprasidone treatment. The authors suggest that the rapid increase in ziprasidone serum levels after parenteral application may have affected lithium excretion, leading to lithium intoxication.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Best clinical practice with ziprasidone IM: update after 2 years of experience.

Author: ZimbroffDan L, AllenMichael H, BattagliaJohn, CitromeLeslie, FishkindAvrim, FrancisAndrew, HerrDaniel L, HughesDouglas, MartelMarc, PrevalHoracio, RossRuth

Agitation treatment
Dizziness
Headache
Hypertension
Insomnia
QTc interval changes

Ziprasidone (Geodon) is the first second-generation antipsychotic to become available in an i.m. formulation. Ziprasidone IM was approved by the Food and Drug Administration in 2002 for the treatment of agitation in patients with schizophrenia. In clinical trials, patients treated with ziprasidone IM demonstrated significant and rapid reduction in agitation and improvement in psychotic symptoms, agitation, and hostility. Tolerability of ziprasidone IM was superior to that of haloperidol IM, with a lower burden of movement disorders. The most common adverse events associated with ziprasidone IM were insomnia, headache, and dizziness.

Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Parenteral ziprasidone: a new atypical neuroleptic for emergency treatment of psychosis in Parkinson's disease?

Author: OechsnerMatthias, KorchounovAlexei

Treatment of agitation

Intramuscular injection of ziprasidone effectively treated acute agitation in five patients with psychosis in Parkinson's disease without significant side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Ziprasidone and haloperidol in the treatment of acute exacerbation of schizophrenia and schizoaffective disorder: comparison of intramuscular and oral formulations in a 6-week, randomized, blinded-assessment study.

Author: BrookShlomo, WaldenJeorg, BenattiaIsma, SiuCynthia O, RomanoSteven J

Efficacy improvement
Tolerability improvement
None specified

Ziprasidone is more effective and has better tolerability than haloperidol in treating acute schizophrenia, with significantly better outcomes for negative symptoms. However, both drugs had similar effectiveness at the end of treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Intramuscular preparations of antipsychotics: uses and relevance in clinical practice.

Author: AltamuraA Cario, SassellaFrancesca, SantiniAnnalisa, MontresorClauno, FumagalliSara, MundoEmanuela

Acute psychosis
Compliance
Improved tolerability
Extrapyramidal side effects
Hypotension

This study reviews the use of intramuscular formulations of antipsychotics, both short-acting and long-acting (depot) preparations. Short-acting formulations are used for managing acute psychotic episodes, while long-acting formulations are used for maintenance treatment to ensure compliance.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Intramuscular ziprasidone, 2 mg versus 10 mg, in the short-term management of agitated psychotic patients.

Author: LesemM D, ZajeckaJ M, SwiftR H, ReevesK R, HarriganE P

Agitation control
Side effects

There is a need for effective and well-tolerated intramuscular agents for the acute control of agitated psychotic patients. Current treatments often have distressing side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Successful treatment of tardive lingual dystonia with botulinum toxin: case report and review of the literature.

Author: HenningsJohannes M H, KrauseEike, BötzelKai, WetterThomas C

Tardive dyskinesia treatment
Minor side effects

Botulinum toxin A injection can significantly improve tardive dyskinesia, as demonstrated in a case of severe tongue protrusion dystonia.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

A naturalistic evaluation of intramuscular ziprasidone versus intramuscular olanzapine for the management of acute agitation and aggression in children and adolescents.

Author: KhanShamima S, MicanLisa M

Effective for aggression

Intramuscular ziprasidone and intramuscular olanzapine may be equally effective in treating aggression in youth.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Intramuscular ziprasidone treatment of acute psychotic agitation in elderly patients with schizophrenia.

Author: BarakYoram, MazehDoron, PlopskiIgor, BaruchYehuda

Acute psychosis treatment

Intramuscular ziprasidone treatment has been shown to be effective and well tolerated in reducing the symptoms of acute psychosis in adults. Further research is needed to evaluate its safety in elderly patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Lithium intoxication associated with intramuscular ziprasidone in schizoaffective patients.

Author: MiodownikChanoch, HausmannMichael, FrolovaKatherina, LernerVladimir

Mood disorder treatment
Lithium intoxication

This report describes two schizoaffective patients who developed lithium intoxication after intramuscular ziprasidone treatment. The authors suggest that the rapid increase in ziprasidone serum levels after parenteral application may have affected lithium excretion, leading to lithium intoxication.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Best clinical practice with ziprasidone IM: update after 2 years of experience.

Author: ZimbroffDan L, AllenMichael H, BattagliaJohn, CitromeLeslie, FishkindAvrim, FrancisAndrew, HerrDaniel L, HughesDouglas, MartelMarc, PrevalHoracio, RossRuth

Agitation treatment
Dizziness
Headache
Hypertension
Insomnia
QTc interval changes

Ziprasidone (Geodon) is the first second-generation antipsychotic to become available in an i.m. formulation. Ziprasidone IM was approved by the Food and Drug Administration in 2002 for the treatment of agitation in patients with schizophrenia. In clinical trials, patients treated with ziprasidone IM demonstrated significant and rapid reduction in agitation and improvement in psychotic symptoms, agitation, and hostility. Tolerability of ziprasidone IM was superior to that of haloperidol IM, with a lower burden of movement disorders. The most common adverse events associated with ziprasidone IM were insomnia, headache, and dizziness.

Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Parenteral ziprasidone: a new atypical neuroleptic for emergency treatment of psychosis in Parkinson's disease?

Author: OechsnerMatthias, KorchounovAlexei

Treatment of agitation

Intramuscular injection of ziprasidone effectively treated acute agitation in five patients with psychosis in Parkinson's disease without significant side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Ziprasidone and haloperidol in the treatment of acute exacerbation of schizophrenia and schizoaffective disorder: comparison of intramuscular and oral formulations in a 6-week, randomized, blinded-assessment study.

Author: BrookShlomo, WaldenJeorg, BenattiaIsma, SiuCynthia O, RomanoSteven J

Efficacy improvement
Tolerability improvement
None specified

Ziprasidone is more effective and has better tolerability than haloperidol in treating acute schizophrenia, with significantly better outcomes for negative symptoms. However, both drugs had similar effectiveness at the end of treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

26.

Choice of maintenance medication for schizophrenia.

Author: DavisJohn M, ChenNancy

Reduced schizophrenia relapse
Antipsychotic side effects

This article addresses the importance of choosing the most effective antipsychotic medication for successful maintenance treatment of schizophrenia, considering efficacy and side effects. While data from acute trials are often relied upon, newer-generation antipsychotics like risperidone and olanzapine have shown better efficacy and a more favorable side effect profile compared to conventional-generation antipsychotics.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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