ABSTRACT
Ziprasidone Ziprasidone has been available in the USA and some European countries for several years. It is a D2:5HT2 antagonist with significant agonist activity at 5HT1A receptors and moderately potent inhibition of monoamine reuptake1,2. Efficacy is similar to haloperidol3 and tolerability is good; most adverse effects occur at the same frequency as placebo and EPSEs, hyperprolactinaemia and weight gain are uncommon4,5. More recent studies suggest that ziprasidone is more effective in the treatment of negative symptoms than haloperidol6 and as effective as amisulpride7. Ziprasidone has a moderate effect on the QT interval which may, at least in theory, make it relatively more likely than other antipsychotics to cause ventricular arrhythmia (see page 75)8. This potential problem should be set against the clear advantages of ziprasidone in relation to weight gain9 and impaired glucose tolerance10.
