A retrospective chart review of intramuscular ziprasidone for agitation in children and adolescents on psychiatric units: prospective studies are needed.
OBJECTIVE
Our primary objective was to evaluate the effectiveness and tolerability of intramuscular ziprasidone for impulsivity and agitation in psychiatrically hospitalized children and adolescents. Our secondary objective was to examine demographic and clinical factors associated with treatment response.


METHODS
We conducted a retrospective chart review of children and adolescents admitted to Cincinnati Children's Hospital Medical Center (CCHMC) psychiatric units between January 1, 2002, and July 11, 2005, who received intramuscular ziprasidone. Medical records were reviewed to determine demographic and clinical information as well as tolerability and effectiveness of ziprasidone. The Behavioral Activity Rating Scale (BARS) was used retrospectively to assess clinical response. Regression analyses were performed to evaluate the effect of demographic factors (age, gender, and ethnicity) and primary psychiatric diagnoses on treatment response. Electrocardiogram (ECG) data was inadequate.


RESULTS
Fifty nine children and adolescents received a total of 77 injections of intramuscular ziprasidone for acute agitation. The mean +/- SD BARS score decreased from 6.5 +/- 0.7 to 3.1 +/- 1.3. The most common side effect was drowsiness or falling asleep (n = 46, 60%). Three (4%) could not be roused after the injection.


CONCLUSIONS
Intramuscular ziprasidone may be helpful for agitation but often caused oversedation. Safety data, including ECGs, is needed in controlled prospective studies.
Barzman
Drew H
DH
Children's Hospital Medical Center, Division of Child and Adolescent Psychiatry, Cincinnati, Ohio 45229-3039, USA. drew.barzman@fuse.net
DelBello
Melissa P
MP
Forrester
Jacob J
JJ
Keck
Paul E
PE
Strakowski
Stephen M
SM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011567:Psychiatric Department, Hospital; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000150:complications / Q000188:drug therapy*; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D012894:Sleep Stages / Q000187:drug effects*; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome