Uses of Zipradon: - Schizophrenia - Mania Schizophrenia, Bipolar Disorder, Mania Concomitant use of oral and IM ziprasidone. Recent acute MI, decompensated heart failure, cardiac arrhythmias, conditions that may increase QT interval eg, QT-interval prolongation or history of QT prolongation; prolactin dependent tumours. Lactation. Not for treatment of behavioural disorders in elderly with dementia.

Atypical neuroleptic drugs

Ziprasidone, a benzylisothiazolylpiperazine is an atypical antipsychotic which may produce antischizophrenic effect by the antagonism of central dopamine D2 receptors and central type 2 serotonergic (5-HT2) receptors.

How to use Ziprasidone: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Ziprasidone is to be taken with food. Administration: Should be taken with food. Adult Dose: Oral Schizophrenia Adult: As ziprasidone HCl: Initially, 20 mg bid, increase if necessary at intervals of not <2 days up to 80 mg bid. Maintenance: 20 mg bid. Acute mixed or manic episodes in bipolar disorder Adult: As ziprasidone HCl: Initially, 40 mg bid, increased to 60 mg or 80 mg bid on the 2nd day. Adjust subsequent doses according to patient's response and tolerance level. Maintenance treatment of bipolar I disorder (adjunctive therapy to either lithium or valproate): Continue at the same dosage on which the patient was initially stabilised w/in 40-80 mg bid. Elderly: Lower initial dose and slower titration. Hepatic impairment: Use caution Renal Dose: Renal impairment: Dose adjustment not necessary with PO administration;

Antagonistic effect with levodopa and dopamine antagonists. Additive hypotensive effect with antihypertensives. Additive sedative effects with other CNS agents, alcohol. Potentially Fatal: Increased risk of torsades de pointes with drugs that prolong QT interval e.g. dofetilide, quinidine, sotalol, and other Class Ia and III antiarrhythmics, moxifloxacin, pimozide, sparfloxacin, thioridazine.

Concomitant use of oral and IM ziprasidone. Recent acute MI, decompensated heart failure, cardiac arrhythmias, conditions that may increase QT interval eg, QT-interval prolongation or history of QT prolongation; prolactin dependent tumours. Lactation. Not for treatment of behavioural disorders in elderly with dementia.

Common - Headache - Nausea - Vomiting - Sleepiness - Abnormal vision - Dystonia (involuntary muscle contractions) - Akathisia (inability to stay still) - Weakness - Parkinsonism - Dizziness - Respiratory tract infection >10% Somnolence (11-15%),Headache (11%),Nausea (4-12%),Extrapyramidal symptoms (2-31%),Dizziness (3-16%) 1-10% Respiratory disorders (1-8%),Constipation (2-9%),Dyspepsia (1-8%),Rash (4-5%),Tachycardia (2%),Hypoesthesia (2%),Priapism (1%),Orthostatic hypotension (5%),Xerostomia (1-5%),Anorexia (2%),Myalgia (2%),Rhinitis (1-4%),Cough (3%) <1% Syncope,Seizures Frequency Not Defined Prolongation of QT interval,Neuroleptic malignant syndrome (NMS),Hyperprolactinemia,Drug reaction with eosinophilia and systemic syntoms Potentially Fatal: Blood dyscrasias, neuroleptic malignant syndrome.

Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Precaution: Patient w/ history of seizures or conditions that lower the seizure threshold, CV or cerebrovascular disease, conditions which predispose to hypotension. Renal impairment. Elderly w/ dementia-related psychosis. Pregnancy and lactation. Patient Counselling This drug may cause somnolence, impairment of judgment, thinking or motor skills, if affected, do not drive, operate machinery or perform hazardous tasks. Avoid alcohol. Monitoring Parameters Monitor serum electrolytes if on concurrent diuretic therapy. Monitor ECG in patients who show symptoms of torsades de pointes (e.g. syncope, dizziness, palpitations); wt gain. Closely monitor worsening of glucose control in patients w/ pre-existing DM. Frequently monitor CBC during 1st few mth of therapy in patients w/ pre-existing low leucocyte count or history of drug-induced leucopenia or neutropenia. Lactation: Unknown if excreted in breast milk; not recommended

Symptoms: Minimal sedation, slurred speech, transitory HTN, extrapyramidal symptoms, somnolence, tremor, anxiety. Management: Establish and maintain an airway, ensure adequate oxygenation and ventilation. Consider admin of activated charcoal together with a laxative, gastric lavage (after intubation for unconscious patient); established IV access. Treat hypotension and circulatory collapse with IV fluids. In case of severe extrapyramidal symptoms, anticholinergic medication should be given.

Store between 15-30° C.

Ziprasidone, an atypical antipsychotic, produces antischizophrenic effect through a combination of dopamine D2 and serotonin 5H2 receptor antagonism.