This study evaluated the efficacy and tolerability of ziprasidone after a switch from conventional and atypical antipsychotics in acute schizophrenic patients who required alternative medication.

A total of 189 patients with acute exacerbation of schizophrenia were switched to 8 weeks of open-label treatment with ziprasidone (80 mg/d for the first 2 days, then adjusted to 40-160 mg/d). Current treatments were discontinued over Days 1-7. Primary efficacy measure was the change from baseline in PANSS total score.

A total of 82.5% of patients switched to ziprasidone due to inadequate efficacy and 16.4% due to poor tolerability (most frequently weight gain). A total of 136 patients (72%) completed the study. After switching to ziprasidone, the mean change (ITT-LOCF)in PANSS total score from baseline to end point was statistically significant (n = 183; baseline score 112 ± 19; mean change -25 ± 25.5; P <.0001). A significant improvement was observed from Week 1. Ziprasidone was generally well tolerated, with 12.7% of patients discontinuing due to adverse events. Movement disorder and sexual dysfunction occurred infrequently, accompanied by baseline-to-end–point reductions in Simpson Angus Scale total score and serum prolactin levels. Switch to ziprasidone showed a significant mean baseline-to-end–point decrease in weight (-1.0 ± 3.1 kg; P< .0001) and a nonsignificant increase (5 ms) in mean QTc interval.

Eight weeks of treatment with ziprasidone significantly reduced overall psychopathology in acute schizophrenic patients switched from other antipsychotics and was well tolerated, with a neutral effect on body weight.