The effectiveness of cross-tapering switching to ziprasidone in patients with schizophrenia or schizoaffective disorder.
OBJECTIVE
Switching antipsychotics is one useful therapeutic option when the treatment of schizophrenia encounters suboptimal efficacy and intolerability issues. This study aimed to investigate the efficacy and tolerability of cross-tapering switching to ziprasidone from other antipsychotics.


METHODS
A total of 67 patients with schizophrenia or schizoaffective disorder were recruited in this 12-week, multicenter, non-comparative, open-label trial. Prior antipsychotics were allowed to be maintained for up to 4 weeks during the titration of ziprasidone. Efficacy was primarily measured using the 18-item Brief Psychotic Rating Scale (BPRS) at baseline, 4 weeks, 8 weeks, and 12 weeks. Efficacy was secondarily measured by the Clinical Global Impression-Severity (CGI-S) scale and the Global Assessment of Functioning (GAF) scale at each visit. Regarding the metabolic effects of switching to ziprasidone, weight, body mass index (BMI), waist-to-hip ratio (WHR), and lipid profile-including triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol levels-were measured at each follow-up visit.


RESULTS
The BPRS scores were significantly improved at 12 weeks after switching to ziprasidone (F=5.96, df=2.11, p=0.003), whereas the CGI-S and GAF scores were not significantly changed. BMIs, WHRs, and TG levels were significantly decreased, with no significant changes in other lipid profiles.


CONCLUSIONS
Cross-tapering switching to ziprasidone is effective for patients with schizophrenia spectrum disorders. Beyond the efficacy of the procedure, favorable metabolic profiles show that switching to ziprasidone may be helpful for maintenance therapy over an extended period.
Department of Psychiatry, Korea University College of Medicine, Ansan Hospital, Ansan, Republic of Korea.
Young-Hoon
YH
Ko
Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Kyoung-Sae
KS
Na
Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea.
Chul-Eung
CE
Kim
Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea.
Seung-Hyun
SH
Kim
Department of Psychiatry, Incheon St. Mary's Hospital, The Catholic University of Korea College of Korea, Incheon, Republic of Korea.
Yang-Whan
YW
Jeon
Department of Psychiatry, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Jung-Seo
JS
Yi
Department of Psychiatry, Incheon St. Mary's Hospital, The Catholic University of Korea College of Korea, Incheon, Republic of Korea.
Moon-Soo
MS
Lee
Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
Shin-Gyeom
SG
Kim
Department of Psychiatry, Incheon St. Mary's Hospital, The Catholic University of Korea College of Korea, Incheon, Republic of Korea.
Hyun-Ghang
HG
Jeong
Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
Han-Yong
HY
Jung
Pharmacotherapy; Schizophrenia; Switching; Triglyceride; Ziprasidone