Ziprasidone Augmentation for MDD Appears Safe, But Precautions Advised

Although the atypical antipsychotic ziprasidone has shown promise as an add-on therapy for patients with major depressive disorder (MDD), little is known of possible side effects from this intervention. Astudy in theJournal of Clinical Psychiatry now suggests that patients with MDD who take ziprasidone in combination with escitalopram may be at greater risk of weight gain, akathisia, and an increase in the QT interval compared with those taking escitalopram alone. The findings were based on a randomized, double-blind, placebo-controlled trial of 139 adults with MDD who were assigned to take ziprasidone (mean dose of 98 mg/d) or placebo in combination with escitalopram for eight weeks after failing to respond to escitalopram alone. As waspreviously reported in theAmerican Journal of Psychiatry, ziprasidone used adjunctively with escitalopram demonstrated greater antidepressant efficacy in patients with MDD compared with adjunctive placebo. As part of this trial, the researchers regularly measured metabolic and cardiac effects, and the Barnes Akathisia Scale and Abnormal Involuntary Movement Scale were used to assess akathisia and extrapyramidal symptoms, respectively.In a follow-up analysis, David Mischoulon, M.D., Ph.D., of Massachusetts General Hospital and colleagues reported that patients on ziprasidone treatment had a significant increase in weight compared with placebo —with the ziprasidone-treated patients averaging a weight gain of 7.7 pounds compared with ...
Source: Psychiatr News - Category: Psychiatry Tags: AJP antipsychotic-induced weight gain David Mischoulon depression escitalopram Journal of Clinical Psychiatry MDD QT prolongation ziprasidone Source Type: research