title: Practical guidance for prescribing ziprasidone in acute manic or mixed episodes of bipolar I disorder.
abstract: BACKGROUND
  Limited information is available on the clinical issues and strategies for optimal clinical usage of ziprasidone in the treatment of adult patients with acute manic or mixed episodes of bipolar disorder.
  
  
  METHODS
  To address those issues, information from clinical trials addressing the efficacy and tolerability of ziprasidone in acute bipolar mania was reviewed and supplemented with the input from an expert faculty of European psychiatrists with extensive experience in treating patients with bipolar mania, both in clinical trials and in everyday clinical practice.
  
  
  CONCLUSIONS
  Effective use of oral ziprasidone in the treatment of acute bipolar mania requires rapid titration to doses in the range 120 - 160 mg/day and administration with meals of ≥ 500 kcal. As in the clinical trials, temporary short-term use of benzodiazepines (in particular lorazepam for agitation or temazepam for insomnia) could be advisable. Available evidence from randomized clinical trials in combination with clinical experience supports the use of ziprasidone as one of the first-line effective and safe treatments for acute manic or mixed episodes associated with bipolar I disorder.
authors.affiliation: Hospital Dr Rodríguez Lafora, Department of Psychiatry, Cra de Colmenar, Viejo Km 13.8, 28049 Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cañas
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Andrea
authors.initials: A
authors.lastname: Fagiolini
authors.forename: Ilkka
authors.initials: I
authors.lastname: Larmo
authors.forename: Pedro
authors.initials: P
authors.lastname: Levy
authors.forename: Georgios
authors.initials: G
authors.lastname: Papageorgiou
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
authors.forename: Marhias
authors.initials: M
authors.lastname: Zink
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Montes
mesh_terms: D000208:Acute Disease; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D015394:Molecular Structure; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone