Expert Canadian consensus suggestions on the rational, clinical use of ziprasidone in the treatment of schizophrenia and related psychotic disorders

Stan Kutcher¹, Sarah J Brooks¹, David M Gardner², Bill Honer³, Lili Kopala³, Alain Labelle⁴, Pierre Lalonde⁵, Ashok Malla⁶, Heather Milliken¹, Jorge Soni⁷, Richard Williams³

¹Department of Psychiatry and ²College of Pharmacy, Dalhousie University, Halifax, NS, Canada; ³Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; ⁴University of Ottawa, Ottawa, ON, Canada; ⁵Faculty of Medicine, University of Montréal, Montréal, QC, Canada; ⁶McGill University, Montréal, QC, Canada; ⁷Department of Psychiatry, University of Toronto, Toronto, ON, Canada

Abstract: Many atypical antipsychotic medications are becoming available for clinical use. Ziprasidone is a recent addition to this group and is expected to become available for clinical use in Canada in 2005. Ziprasidone has some significant differences compared with other atypicals currently available in Canada. Clinicians need to understand the benefits and risks associated with each of the antipsychotic medications available for the treatment of schizophrenia and related psychotic disorders to ensure their most appropriate utilization. At the suggestion of Professor Stan Kutcher (chair) and as part of an ongoing commitment to provide independent education pertaining to the utility of new psychotropic compounds to health professionals, a panel of Canadian experts in the treatment of schizophrenia spectrum disorders was convened to provide consensus suggestions for the appropriate clinical use of ziprasidone. The consultations regarding the development of these recommendations were organized by Brainworks International (BWI) with arms-length funding from Pfizer Canada. This paper describes the experts’ consensus views on the efficacy and safety of ziprasidone, their suggestions on which patients may be suitable for ziprasidone treatment, and how to initiate treatment (including how to switch from other antipsychotic medications), manage side effects, and monitor patients in long-term therapy. These suggestions are those of the authors only and are not endorsed by or necessarily reflect the opinions of BWI or Pfizer Canada.

Keywords: schizophrenia, treatment, ziprasidone, consensus, schizoaffective, atypical antipsychotic, psychosis