Practical guidance for prescribing ziprasidone in acute manic or mixed episodes of bipolar I disorder.

Introduction: Limited information is available on the clinical issues and strategies for optimal clinical usage of ziprasidone in the treatment of adult patients with acute manic or mixed episodes of bipolar disorder.

Areas Covered: To address those issues, information from clinical trials addressing the efficacy and tolerability of ziprasidone in acute bipolar mania was reviewed and supplemented with the input from an expert faculty of European psychiatrists with extensive experience in treating patients with bipolar mania, both in clinical trials and in everyday clinical practice.

Expert Opinion: Effective use of oral ziprasidone in the treatment of acute bipolar mania requires rapid titration to doses in the range 120 - 160 mg/day and administration with meals of ≥ 500 kcal.

Strategies for successful clinical management of schizophrenia with ziprasidone.

Importance Of The Field: This review addresses practical clinical issues related to the use of ziprasidone in the treatment of schizophrenia using information from clinical trials, unpublished data, manufacturer's information, and input from an expert faculty of European psychiatrists with extensive experience of the use of ziprasidone, both in clinical trials and in everyday clinical practice.

Areas Covered In This Review: A Medline search of published data (1998 - 2010) was carried out, together with a review of unpublished data and manufacturer's information. In addition, expert opinion was sought from psychiatrists with extensive experience of ziprasidone in the treatment of schizophrenia in clinical settings across Europe.

Efficacy and tolerability of quetiapine in patients with schizophrenia who switched from haloperidol, olanzapine or risperidone.

A post hoc analysis of the SPECTRUM trial was carried out to evaluate whether the improvements in efficacy and tolerability gained on switching to quetiapine occurred consistently for patients previously treated with either: haloperidol (n = 43); olanzapine (n = 66); or risperidone (n = 55) monotherapy. Patients were initiated with quetiapine to 400 mg/day over 7 days, and then flexibly dosed (300-750 mg/day) for 11 weeks. The mean (SD) modal dose of quetiapine was 501 (138) mg/day in the haloperidol subgroup, 472 (147) mg/day in the olanzapine subgroup and 485 (141) mg/day in the risperidone subgroup at the study endpoint.

Oral risperidone plus oral lorazepam versus standard care with intramuscular conventional neuroleptics in the initial phase of treating individuals with acute psychosis.

Although atypical antipsychotics are now considered first line treatments for schizophrenia, intramuscular (i.m.) conventional neuroleptics are often still considered necessary in emergency treatment of acute psychoses.

Reversal of antipsychotic-induced weight gain during quetiapine treatment.

Weight gain in mentally ill patients is an evident problem, and obesity can be two- to three-fold more prevalent in psychiatric patients than in the general population. We report two patients who gained weight during previous antipsychotic treatment but who lost weight when shifted to quetiapine.

Antipsychotic drug treatment in the prodromal phase of schizophrenia.

Objective: The safety and tolerability of short-term treatment with a low dose of risperidone was evaluated in adolescents with prodromal symptoms and a family history of schizophrenia.

Method: Four prodromal high-risk adolescents and six first-episode patients with schizophrenia were treated with average doses of 1.0 and 1.