PMID- 21430488
OWN - NLM
STAT- MEDLINE
DCOM- 20110728
LR  - 20221207
IS  - 1538-1145 (Electronic)
IS  - 1527-4160 (Linking)
VI  - 17
IP  - 2
DP  - 2011 Mar
TI  - Switching from quetiapine to ziprasidone: a sixteen-week, open-label, multicenter 
      study evaluating the effectiveness and safety of ziprasidone in outpatient 
      subjects with schizophrenia or schizoaffective disorder.
PG  - 100-9
LID - 10.1097/01.pra.0000396061.05269.c8 [doi]
AB  - OBJECTIVE: The objectives of this study were to evaluate the effects of switching 
      from quetiapine to ziprasidone on weight, safety, and effectiveness METHODS: In 
      this study, 241 subjects with schizophrenia or schizo affective disorder who had 
      been treated with quetiapine (>/=300 mg/day) for >/=3 months with either suboptimal 
      efficacy or poor tolerability were enrolled in a 16-week, open-label, 
      flexible-dose trial, with a 16-week follow-up (total 32 weeks). Quetiapine was 
      tapered and discontinued over the course of 2 weeks, while ziprasidone was 
      titrated up and dosed at 40-80 mg b.i.d. The primary endpoint was weight change 
      (kg) from baseline at 16 weeks. Secondary endpoints were change in waist/hip 
      circumference, lipid profile, fasting glucose, and glycosylated hemoglobin 
      (HbA1c). Additional secondary endpoints included changes in scores on the 
      Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions 
      Improvement and Severity Scales (CGI-I and CGI-S), the Calgary Depression Scale 
      for Schizophrenia (CDSS), the Schizophrenia Cognition Rating Scale (ScoRS), and 
      the Global Assessment of Functioning (GAF). Safety measures included adverse 
      event (AE) reporting and administration of the Abnormal Involuntary Movement 
      Scale (AIMS). RESULTS: At week 16, there was a small but statistically 
      significant decrease in weight, with a mean change from baseline of -0.73 kg 
      (1-sided 95% upper confidence bound=-0.33) using the last observation carried 
      forward [LOCF] approach. There were small mean decreases in levels of total 
      cholesterol, low density lipoprotein (LDL), and triglycerides at week 16, but no 
      change in fasting glucose or HbA1c. At week 16, there were also significant 
      changes indicating improvement in the secondary clinical assessments, including 
      the PANSS scores, CGI-S, CDSS, SCoRS and GAF. There was no change in the AIMS. 
      AEs included insomnia (12.4%), somnolence (13.7%), and nausea (9.1%). CONCLUSION: 
      Subjects switching from quetiapine to ziprasidone showed a small but significant 
      decrease in weight as well as improved lipid profiles, regardless of their 
      metabolic status and disease severity at baseline. Subjects also showed 
      improvement in clinical symptoms and in cognitive functioning. Ziprasidone, with 
      a comparatively neutral metabolic profile relative to other antipsychotics, may 
      be an effective treatment alternative for patients experiencing weight gain or 
      lack of tolerability with quetiapine.
FAU - Karayal, Onur N
AU  - Karayal ON
AD  - Pfizer Inc., 235 East 42nd Street, New York, NY 10017, USA. 
      onur.karayal@pfizer.com
FAU - Glue, Paul
AU  - Glue P
FAU - Bachinsky, Mary
AU  - Bachinsky M
FAU - Stewart, Michelle
AU  - Stewart M
FAU - Chappell, Phillip
AU  - Chappell P
FAU - Kolluri, Sheela
AU  - Kolluri S
FAU - Cavus, Idil
AU  - Cavus I
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Psychiatr Pract
JT  - Journal of psychiatric practice
JID - 100901141
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Blood Glucose)
RN  - 0 (Dibenzothiazepines)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Piperazines)
RN  - 0 (Thiazoles)
RN  - 0 (Triglycerides)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 2S3PL1B6UJ (Quetiapine Fumarate)
RN  - 6UKA5VEJ6X (ziprasidone)
RN  - 97C5T2UQ7J (Cholesterol)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antipsychotic Agents/administration & dosage/*adverse effects
MH  - Blood Glucose
MH  - Body Weight/drug effects
MH  - Cholesterol/blood
MH  - Cognition/drug effects
MH  - Dibenzothiazepines/administration & dosage/*adverse effects
MH  - Drug Administration Schedule
MH  - Female
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outpatients
MH  - Piperazines/administration & dosage/*adverse effects
MH  - Psychiatric Status Rating Scales
MH  - Psychotic Disorders/*drug therapy
MH  - Quetiapine Fumarate
MH  - Schizophrenia/*drug therapy
MH  - Thiazoles/administration & dosage/*adverse effects
MH  - Treatment Outcome
MH  - Triglycerides/blood
MH  - Young Adult
EDAT- 2011/03/25 06:00
MHDA- 2011/07/29 06:00
CRDT- 2011/03/25 06:00
PHST- 2011/03/25 06:00 [entrez]
PHST- 2011/03/25 06:00 [pubmed]
PHST- 2011/07/29 06:00 [medline]
AID - 00131746-201103000-00004 [pii]
AID - 10.1097/01.pra.0000396061.05269.c8 [doi]
PST - ppublish
SO  - J Psychiatr Pract. 2011 Mar;17(2):100-9. doi: 10.1097/01.pra.0000396061.05269.c8.