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Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2002 September;43(3):221-32

language: Italian

Metanalysis of the placebo-controlled clinical studies on the antipsychotic efficacy of Ziprasidone in acute disorders

Loriedo C., Bianchi G., Perrella C., Raccah C., Vella G.


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Ziprasidone is a new antipsychotic drug with a receptor binding profile that differentiates this compound from other antipsychotics. It has a high 5-HT2/D2 receptor affinity ratio, it is a potent 5-HT1a receptor agonist, a potent 5-HT1d and 5-HT2c receptor antagonist and moderately inhibits 5-HT and norepinephrine reuptake sites in vitro. It has negligible muscarinic M1 activity and only modest affinity for H1 and alfa1 receptors. This profile suggests efficacy in the treatment of positive, negative and affective symptoms of schizophrenia. It also suggests low liability for extrapyramidal symptoms, cardiovascular side-effects, sedation and cognitive impairment. We examined, by a metanalytic method, data of two studies of 4 week randomised, double-blind, fixed dose with Ziprasidone 40-120/160 mg versus placebo, at 17, 20, and 17 patients respectively in the first study and in 47, 43, 41 patients in the second. We have combined the percentage data of responders found in these studies and calculated the difference in responder percentage. Clinical efficacy was evaluated using BPRS and CGI rating scales. The results of the metanalysis demonstrate that Ziprasidone 160 mg/day is consistently and significantly more effective than placebo and Ziprasidone 40 mg both in reducing psychopathology scores and in improving positive and negative symptoms. We present data of the last study to evaluate the tolerability, safety and efficacy of the treatment with the intramuscular formulation of the novel antipsychotic.

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