Single-dose ziprasidone associated with QT interval prolongation

Witsil, Joanne C.; Zell-Kanter, Michele; Mycyk, Mark B.

doi:10.1016/j.ajem.2011.03.019

Cited by 9 publications

(15 citation statements)

References 6 publications

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“…In comparison, aripiprazole79,102,103 and ziprasidone104,105 cause less weight gain and sedation, although there was no obvious trend in favor of aripiprazole regarding weight gain in a long-term observation study,52 and no RCTs have been conducted regarding the use of ziprasidone among autistic children. Furthermore, the potential QTc interval prolongation with ziprasidone has been reported 75–77. Contrary to ziprasidone, no changes were evident in the QT interval in any trials for aripiprazole 9,10,73.…”

Section: Resultsmentioning

confidence: 92%

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Efficacy and Tolerability of Pharmacotherapy Options for the Treatment of Irritability in Autistic Children

Kirino

2014

Clin Med Insights Pediatr

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Children with autism have a high rate of irritability and aggressive symptoms. Irritability or self-injurious behavior can result in significant harm to those affected, as well as to marked distress for their families. This paper provides a literature review regarding the efficacy and tolerability of pharmacotherapy for the treatment of irritability in autistic children. Although antipsychotics have not yet been approved for the treatment of autistic children by many countries, they are often used to reduce symptoms of behavioral problems, including irritability, aggression, hyperactivity, and panic. However, among antipsychotics, the Food and Drug Administration has approved only risperidone and aripiprazole to treat irritability in autism. Among atypical antipsychotics, olanzapine and quetiapine are limited in their use for autism spectrum disorders in children because of high incidences of weight gain and sedation. In comparison, aripiprazole and ziprasidone cause less weight gain and sedation. However, potential QTc interval prolongation with ziprasidone has been reported. Contrary to ziprasidone, no changes were evident in the QT interval in any of the trials for aripiprazole. However, head-to-head comparison studies are needed to support that aripiprazole may be a promising drug that can be used to treat irritability in autistic children. On the other hand, risperidone has the greatest amount of evidence supporting it, including randomized controlled trials; thus, its efficacy and tolerability has been established in comparison with other agents. Further studies with risperidone as a control drug are needed.

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Section: Resultsmentioning

confidence: 92%

“…Contrary to ziprasidone,75–77 no changes were evident in blood pressure, heart rate, electrocardiography, or QT interval in any of the double-blind, placebo-controlled trials for aripiprazole conducted among children and adolescents with autistic disorder,9,10 or in those conducted with adolescents with schizophrenia 73…”

Section: Resultsmentioning

confidence: 94%

Efficacy and Tolerability of Pharmacotherapy Options for the Treatment of Irritability in Autistic Children

Kirino

2014

Clin Med Insights Pediatr

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“…Nevertheless, our review found two cases [2, 11]; both had reported symptoms related to QTc prolongation.…”

Section: Discussionmentioning

confidence: 99%

“…IM ziprasidone is described as potentially causing QT interval prolongation in large doses or in patients with other risks for interval prolongation [2]. Other antipsychotics, such as sertindole and thioridazine, prolong the QT interval and are associated with cases of torsades de pointes and sudden death [3].…”

Section: Introductionmentioning

confidence: 99%

QT Interval Prolongation Associated with Intramuscular Ziprasidone in Chinese Patients: A Case Report and a Comprehensive Literature Review with Meta-Analysis

Tang

Zheng

et al. 2014

Case Reports in Psychiatry

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Intramuscular (IM) ziprasidone has been associated with QTc interval prolongations in patients with preexisting risk factors. A 23-year-old male Chinese schizophrenia patient experienced an increase of QTc interval of 83 milliseconds (ms) after receiving 20 mg IM ziprasidone (baseline and increased QT/QTc were, respectively, 384/418 and 450/501). This was rated as a probable adverse drug reaction (ADR) by the Liverpool ADR causality assessment tool. A systematic review including all types of trials reporting the effect of IM ziprasidone on the QTc interval prolongation identified 19 trials with a total of 1428 patients. Mean QTc change from baseline to end of each study was −3.7 to 12.8 ms after IM ziprasidone. Four randomized trials (3 of 4 published in Chinese) were used to calculate a meta-analysis of QTc interval prolongation which showed no significant differences between IM ziprasidone and IM haloperidol groups (risk ratio 0.49 to 4.31, 95% confidence interval 0.09 to 19.68, P = 0.06 to 0.41). However, our review included two cases of patients who experienced symptoms probably related to QTc prolongation after IM ziprasidone. Thus, careful screening and close monitoring, including baseline ECG, should be considered in patients receiving IM ziprasidone for the first time.

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“…Regarding side effects, APZ and ZPD are considered promising drugs [11,38]. However, because QT prolongation associated with ZPD has been reported in studies in adults [39,40], possible cardiovascular risk must be considered and the use of ZPD should be limited in children and adolescents. However, no changes were evident in blood pressure, heart rates, ECG, or QT interval, in any of the double-blind, placebocontrolled trials for APZ [23,25,26].…”

Section: Weight Gain Metabolic Consequences and Qt Prolongationmentioning

confidence: 99%

Reelin Associated With Restricted and Stereotyped Behavior Based on Principal Component Analysis on Autism Diagnostic Interview-Revised

et al. 2013

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Background: Although a significant amount of literature regarding use of aripiprazole (APZ) in autistic spectrum disorders (ASDs) has benne published, APZ is not approved for use in autism or ASDs in countries other than the United States. Even in the United States, approved use of APZ is limited to the patients with autism in children and adolescents. This review and case reports focus on the available evidence and clinical experience regarding the use of APZ in patients with ASDs including adults Methods: A literature review was conducted, using the PubMed search term 'aripiprazole'and('autistic spectrum disorder', 'pervasive developmental disorders' or 'Asperger's disorder'). Results:In previous reports, APZ can target symptoms such as anxiety, depression, aggression, and irritability. Compared with other antipsychotics, APZ also causes fewer adverse events that can lead to drug discontinuation. The case reports supported the literature review: APZ has moderate sedative, antidepressant, and antianxiety effects, when used to treat ASDs. None of the patients experienced adverse reactions (e.g., extrapyramidal symptoms, weight gain, and sedation).Conclusion: APZ reduces aggression in ASDs and improves qualitative deficits in interpersonal interactions and motivation. APZ also causes fewer adverse events. APZ may be associated with favorable treatment compliance, and may improve treatment of ASDs.

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Single-dose ziprasidone associated with QT interval prolongation

Cited by 9 publications

References 6 publications

Efficacy and Tolerability of Pharmacotherapy Options for the Treatment of Irritability in Autistic Children

Efficacy and Tolerability of Pharmacotherapy Options for the Treatment of Irritability in Autistic Children

QT Interval Prolongation Associated with Intramuscular Ziprasidone in Chinese Patients: A Case Report and a Comprehensive Literature Review with Meta-Analysis

Reelin Associated With Restricted and Stereotyped Behavior Based on Principal Component Analysis on Autism Diagnostic Interview-Revised

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