| Ziprasidone's Effect on Metabolic Markers in Patients with Diabetes and Chronic Schizophrenia. | |
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MedLine Citation:
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PMID: 22182455 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Despite numerous studies of diabetes mellitus type II (DM-II) in schizophrenia and schizoaffective disorder, there have been no studies on the glycemic effects of switching patients with long-standing symptomatic DM-II from their current antipsychotic regimen to ziprasidone. Methods: An open-label, prospective inpatient study was conducted with 26 suboptimally responding inpatients with DSM-IV diagnoses of schizophrenia or schizoaffective disorder and comorbid DM-II who were switched to ziprasidone monotherapy and followed for 8 weeks. Outcome measures were fasting glucose, triglycerides, cholesterol, insulin levels, capillary blood glucose levels and weight. After a 3-week cross-titration period, patients were treated with ziprasidone up to a dose of 320 mg daily. Results: Of the 26 study participants, 16 completed the entire study period of 63 days and 10 (38.46%) discontinued participation, primarily due to psychotic relapse. There was a statistically significant reduction in fasting glucose (F=4.43, p=0.05; 14.68 mg/dL mean reduction), capillary blood glucose levels (F=8.90, p=0.01; 25.36 mg/dL mean reduction), weight (F=4.46, p=0.05; 4.68 lb mean weight loss) and Body Mass Index (F=4.40, p=0.05; 3.62 kg/m2 mean reduction). There was also a reduction in the use of antidiabetic medications after the switch to ziprasidone. Nine (34.62%) patients met criteria for metabolic syndrome (MetS) at baseline, as compared to 4 (15.38%) at endpoint. No change was observed in positive symptoms (F=0.62, p=0.44), negative symptoms (F=1.47, p=0.24) and in total PANSS score (F=0.12, p=0.74). Conclusions: This study suggests significant improvement in metabolic side effects and MetS in the subset of the patients who were able to tolerate switching from a polypharmacy regimen to ziprasidone. There was a large discontinuation rate, which limited the sustained beneficial effects of ziprasidone. The decision to switch to ziprasidone in patients with prior suboptimal response has to balance the potential metabolic benefits and the potential relapse risks of the individual patient first and foremost. |
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Authors:
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J P Lindenmayer; Frank Tedeschi; Anna Yusim; Anzalee Khan; Saurabh Kaushik; Robert C Smith; Mohan Parakadavil |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical schizophrenia & related psychoses Volume: 5 ISSN: 1935-1232 ISO Abbreviation: Clin Schizophr Relat Psychoses Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2011-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101312513 Medline TA: Clin Schizophr Relat Psychoses Country: United States |
Other Details:
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Languages: eng Pagination: 185-92 Citation Subset: IM |
Affiliation:
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Department of Psychiatry, New York University School of Medicine, New York, NY Manhattan Psychiatric Center, New York, NY Psychopharmacology Research Unit, Nathan Kline Institute for Psychiatric Research, New York, NY. |
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