title: Sertindole in schizophrenia: efficacy and safety issues.
abstract: BACKGROUND
  Despite substantial progress in the pharmacological treatment of schizophrenia, antipsychotic drugs are associated with insufficient effects on negative and cognitive symptoms, adverse events, poor compliance and drug discontinuation. Sertindole , first withdrawn from the market for cardiovascular safety concerns, is currently available in many countries. It has high affinity for dopamine D2, serotonin 5-HT2A, 5-HT2C and a1-adrenergic receptors, and a low potential for extrapyramidal symptoms.
  
  
  METHODS
  The pharmacodynamics, pharmacokinetics, clinical efficacy, safety and tolerability, and cost-effectiveness of sertindole are covered in this article, based on a literature review (PubMed) from 1990 to 2014.
  
  
  CONCLUSIONS
  The reviewed studies suggest a beneficial effect of sertindole on positive, negative and cognitive symptoms, and on relapse prevention. Although generally well tolerated, sertindole is associated with a dose-related QT-interval prolongation; thus, its administration requires electrocardiogram screening and monitoring. The presence of congenital long QT syndrome, prolongated QTc at baseline, cardiac disease and drug interactions should be carefully considered before prescribing sertindole. Further direct 'head-to-head' comparisons with other second-generation antipsychotics (SGAs), trials on special populations and further clarification on cardiac safety are needed to better define the role of sertindole in the treatment of schizophrenia.
authors.affiliation: University of Messina, Department of Neurosciences, Section of Psychiatry , Policlinico Universitario, Via Consolare Valeria - Messina 98125 , Italy +39 090 22212092 ; +39 090 695136 ; antonio.bruno@unime.it.
authors.forename: Maria Rosaria Anna
authors.initials: MR
authors.lastname: Muscatello
authors.forename: Antonio
authors.initials: A
authors.lastname: Bruno
authors.forename: Paolo
authors.initials: P
authors.lastname: Micali Bellinghieri
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pandolfo
authors.forename: Rocco Antonio
authors.initials: RA
authors.lastname: Zoccali
mesh_terms: D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D004347:Drug Interactions; D006801:Humans; D007093:Imidazoles / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D007211:Indoles / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D008133:Long QT Syndrome / Q000139:chemically induced / Q000191:economics; D012008:Recurrence; D012559:Schizophrenia / Q000188:drug therapy* / Q000517:prevention & control; D012565:Schizophrenic Psychology; D055502:Secondary Prevention
chemical_list: D014150:Antipsychotic Agents; D007093:Imidazoles; D007211:Indoles; C066304:sertindole
keywords: atypical antipsychotic; efficacy; safety; schizophrenia; sertindole