Efficacy and Tolerability of Switching to Ziprasidone From Other Antipsychotics

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00458211
Recruitment Status : Completed
First Posted : April 10, 2007
Results First Posted : May 6, 2013
Last Update Posted : August 10, 2015
Buffalo Psychiatric Center
Rochester Psychiatric Center
Information provided by (Responsible Party):
Nigel Bark MD, Bronx Psychiatric Center

Brief Summary:

Because ziprasidone has not been extensively studied and is not widely accepted in the severely mentally ill in State hospitals this study aims to demonstrate its effectiveness and relative lack of side effects. 75 patients with schizophrenia or schizoaffective disorder who need a change of medication because of ineffectiveness or side effects will be changed to ziprasidone and followed with detailed assessments for eight weeks.

The hypothesis is that they will improve and have fewer side effects.

Condition or disease Intervention/treatment Phase
Schizophrenia Schizoaffective Disorder Drug: ziprasidone Phase 4

Detailed Description:

Ziprasidone has been found in studies and practice to be efficacious and tolerated well but has not been well studied or well accepted in the very severely ill in State Hospitals. This study aims to fill that gap by examining 75 patients with schizophrenia or schizoaffective disorder who require a change of medication because of poor response or unacceptable side effects.

After signing consent and having a baseline assessment they will, if necessary, be reduced to one antipsychotic then started on ziprasidone, increasing to 160mg the second day. The one antipsychotic they had been on will be reduced over a week and stopped. The ziprasidone can be increased to 240mg after three weeks if necessary.

The study will last eight weeks with efficacy assessed by Clinical Global Impressions (CGI), Positive and Negative Syndrome Scale (PANSS) every two weeks and Brief Assessment of Cognition, Calgary Depression Scale for Schizophrenia, Personal Evaluation of Transitions in Treatment and Medical Outcomes Study Cognitive Questions at the beginning and end. Side effects will be measured by movement disorder scales (Simpson-Angus scale for Parkinsonism (SANRS), Abnormal Involuntary Movement Scale (AIMS) and Barnes Akathisia Scale (BAS)), ECG and weight and blood metabolic measures.

The hypothesis is that ziprasidone will be generally effective and that side effects especially metabolic indices will be reduced.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 40 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Evaluation of Efficacy and Tolerability of Switching to Ziprasidone From Other Antipsychotic Medications
Study Start Date : May 2005
Actual Primary Completion Date : April 2008
Actual Study Completion Date : April 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Schizophrenia

Arm Intervention/treatment
Experimental: Experimental
Open label change to ziprasidone
Drug: ziprasidone
Ziprasidone by mouth 40mg twice a day (bid) for one day, then 80mg bid; may be increased to 120mg bid after three weeks

Primary Outcome Measures :
  1. Positive and Negative Syndrome Scale (PANSS) Measuring Symptoms of Schizophrenia [ Time Frame: Baseline to 8 weeks ]
    Minimum score 32 (best) maximum 210 (worst)

Secondary Outcome Measures :
  1. Clinical Global Impression (CGI) Scores the Evaluator's Overall Impression of Severity (CGI-S) or Change (CGI-I) in Illness. [ Time Frame: 8 weeks ]
    CGI-S scores from 1 = normal to 7 = most extremely ill

  2. Weight [ Time Frame: 8 weeks ]
  3. Fasting Glucose [ Time Frame: 8 weeks ]
  4. Cholesterol [ Time Frame: 8 weeks ]
  5. Abnormal Involuntary Movement Scale (AIMS) Measures Tardive Dyskinesia [ Time Frame: 8 weeks ]
    Scores 0 (none) to 4 (severe) choreo-athetoid and dystonic movements of seven parts of the body with a maximum score 28

  6. Simpson-Angus Scale Measures Drug Induced Parkinsonism [ Time Frame: 8 weeks ]
    Measures 10 signs, (not all of which are now considered Parkinsonism), minimum score 0 (no Parkinsonism) maximum 40.

  7. QTc [ Time Frame: 8 weeks ]
    Time interval between Q and T waves on EKG corrected for pulse rate. Over 500 msec may be dangerous

  8. BACS [ Time Frame: 8 weeks ]
  9. CDSS [ Time Frame: 8 weeks ]
  10. PETiT [ Time Frame: 8 weeks ]
  11. MOS-COG [ Time Frame: 8 weeks ]
  12. Barnes Akathisia Scale [ Time Frame: 8 weeks ]
  13. HgbA1c [ Time Frame: 8 weeks ]
  14. Insulin Level [ Time Frame: 8 weeks ]
  15. Antipsychotic Medication Costs [ Time Frame: 8 weeks ]

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Schizophrenia or schizoaffective
  • Capacity to give consent
  • Stable, on the same medication for a month but only partial response or with unacceptable side effects 18-65 years of age

Exclusion Criteria:

  • Repeated non-compliance
  • Current depot medication
  • Active medical conditions
  • QTc >500msec
  • Previous non-response
  • Previous treatment with ziprasidone

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00458211

United States, New York
Bronx Psychiatric Center
Bronx, New York, United States, 10461
Buffalo Psychiatric Center
Buffalo, New York, United States, 14213
Sponsors and Collaborators
Bronx Psychiatric Center
Buffalo Psychiatric Center
Rochester Psychiatric Center
Principal Investigator: Nigel Bark, MD Bronx Psychiatric Center
Principal Investigator: Jeffrey Grace, MD Buffalo Psychiatric Center
Principal Investigator: Steven Schwarzkopf, MD Rochester Psychiatric Center

Responsible Party: Nigel Bark MD, Director of Scizophrenia Research, Bronx Psychiatric Center Identifier: NCT00458211     History of Changes
Other Study ID Numbers: BPCIRB 03-02
First Posted: April 10, 2007    Key Record Dates
Results First Posted: May 6, 2013
Last Update Posted: August 10, 2015
Last Verified: July 2015

Keywords provided by Nigel Bark MD, Bronx Psychiatric Center:

Additional relevant MeSH terms:
Psychotic Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Mental Disorders
Antipsychotic Agents
Tranquilizing Agents
Central Nervous System Depressants
Physiological Effects of Drugs
Psychotropic Drugs
Serotonin Antagonists
Serotonin Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Dopamine Antagonists
Dopamine Agents