ziprasidone / Generic mfg. - LARVOL DELTA

Second-generation antipsychotics - Cardiac ion channel modulation and QT interval disturbances: A review. (PubMed, Biomol Biomed) - "A narrative literature review was conducted using PubMed, Web of Science, and Google Scholar, without year restrictions, focusing on English-language experimental and clinical studies related to clozapine, olanzapine, risperidone, quetiapine, and ziprasidone. Notably, the observed variability in the ratio of half-maximal inhibitory concentration to maximum free plasma concentration (IC₅₀/Cmax,free) reflects its dependence on both the degree of hERG inhibition and the pharmacokinetic properties specific to each SGA. Additionally, several SGAs affect other potassium, sodium, and calcium currents, which may either mitigate or exacerbate the consequences of IKr inhibition. In conclusion, QT interval prolongation associated with SGAs is primarily driven by hERG potassium channel blockade, although the degree of this effect varies significantly among different agents. This variability highlights the necessity for electrocardiogram (ECG) monitoring and..."

Journal • Review • Cardiovascular • CNS Disorders • Psychiatry

Post-lanosterol inhibition profile based classification of commonly used prescription medications. (PubMed, Transl Psychiatry) - "Using LC-MS/MS we measured 13 post-lanosterol intermediates in control, DHCR7 +/- and DHCR7-/- human dermal fibroblasts exposed to cariprazine, nebivolol, rotigotine, buspirone, lurasidone, fluoxetine, hydroxyzine, amiodarone, spiroxamine, vilazodone and ziprasidone. In addition, DHCR7 +/- fibroblasts responded with greater sterol profile disruptions to all medications, while DHCR7 fibroblasts from patients with Smith-Lemli-Opitz syndrome showed generally a more plateaued response. Knowing the inhibition profile-based classification of medications that have a sterol inhibiting side effect might ultimately translate into safety recommendations during pregnancy and could be critical for new drug development."

Journal • DHCR7

QT interval prolongation in acute antipsychotic poisoning: systematic review and recommendations. (PubMed, Clin Toxicol (Phila)) - "Individual medication recommendations were made for amisulpride (15 articles), thioridazine (11 articles), ziprasidone (eight articles) and quetiapine (13 articles), whilst consensus statements based on limited data were made for acute ingestions of clozapine, haloperidol, iloperidone, pimozide, pipamperone, olanzapine and risperidone (14 articles in total). The QT Interval Prolongation in Clinical Toxicology Workgroup suggests the same approach for patients with overdoses of haloperidol, iloperidone, pipamperone and pimozide. The risk of torsade de pointes is likely overstated for acute antipsychotic medication overdose as a general class group, and concern should rather focus on a few specific medications."

Journal • CNS Disorders

ECG Changes Associated With Antipsychotic Use: A Case Vignette From the Emergency Department. (PubMed, Adv Emerg Nurs J) - "First- and second-generation antipsychotics, including the commonly used haloperidol and ziprasidone, are known to cause QTc prolongation, the most clinically significant ECG abnormality. Effective management requires individualized assessment, vigilant ECG and electrolyte monitoring, and informed antipsychotic selection. This case study highlights the clinical presentation and potential ECG changes associated with antipsychotic medication use in the ED."

Journal • Cardiovascular • CNS Disorders • Mental Retardation • Psychiatry • Ventricular Tachycardia

Second-Generation Antipsychotics and VTE Risk (ASH 2023) - "Events were then narrowed further to include only those associated with a single second-generation antipsychotic – aripiprazole, clozapine, olanzapine, quetiapine, and ziprasidone. There were a total of 1155 VTE events amongst the six antipsychotics, out of 180824 total reported cases. Olanzapine (308) and quetiapine (273) had the most events overall as well as the most PEs (olanzapine 224, quetiapine 204), while risperidone had the most deep vein thromboses (DVT) (103). When analyzed using the PRR (for which ziprasidone was excluded due to low number of cases and events), olanzapine and quetiapine were disproportionally associated with an increased rate of VTE (2.57 and 2.22 respectively) and PE (2.71 and 2.42 respectively)."

Cardiovascular • CNS Disorders • Hematological Disorders • Respiratory Diseases • Venous Thromboembolism

Curcumin as an Antioxidant Against Ziprasidone Induced Lipid Peroxidation in Human Plasma: Potential Relevance to Cortico Subcortical Circuit Function. (PubMed, Int J Mol Sci) - "Ziprasidone (40 ng/mL, 139 ng/mL, 250 ng/mL) significantly increased TBARS levels, but in the presence of the studied curcumin concentrations, its pro-oxidative effects were reduced by about 56%. Our results confirm that Ziprasidone in vitro may induce lipid peroxidation in human plasma, whereas curcumin protects against lipid peroxidation in human plasma caused by the antipsychotic Ziprasidone."

Journal • CNS Disorders • Mental Retardation • Psychiatry • Schizophrenia

Comparison of ziprasidone and olanzapine on cognitive function in patients with schizophrenia at different stages: a prospective study in Huai'an, China. (PubMed, Front Behav Neurosci) - "Patients with schizophrenia have cognitive dysfunction in the early stage of onset. The combination of ziprasidone and olanzapine can effectively improve cognitive dysfunction and promote the recovery of social functions of patients."

Journal • CNS Disorders • Cognitive Disorders • Psychiatry • Schizophrenia

Gaps in the detection of drug-drug interactions between antipsychotic and cardiometabolic medications: a multisource analysis. (PubMed, BMC Med) - "This systematic review and disproportionality analysis identified potential DDIs between antipsychotic medications and cardiometabolic medications, many of which were not captured by commonly used DDI checkers. These findings underscore the need for clinicians to consult multiple sources and apply clinical judgment when prescribing these medications. Improved integration of pharmacovigilance data into DDI checkers may enhance the identification and prevention of harmful interactions."

Journal • Cardiovascular • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Metabolic Disorders • Musculoskeletal Diseases • Rheumatology

Impact of selected second and third generation antipsychotics on cognitive dysfunction in schizophrenia-spectrum disorders. Systematic review and network meta-analysis. (PubMed, Int Clin Psychopharmacol) - "This study aimed to: (a) systematically review randomized controlled trials (RCTs) evaluating the cognitive effects of third-generation antipsychotics (TGAs: brexpiprazole, cariprazine, lumateperone, and lurasidone) and xanomeline-trospium; and (b) perform a network meta-analysis (NMA) including additional second-generation antipsychotics with potential procognitive effects. A systematic literature search identified eligible RCTs, which were combined with trials on aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone from a previous meta-analysis...In conclusion, selected second and TGAs, including M1/M4 receptor agonists such as xanomeline, may offer promising treatment options for cognitive dysfunction. Further research should personalize pharmacological strategies based on cognitive profiles."

Journal • Retrospective data • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Cognitive Disorders • Psychiatry • Schizophrenia

Grading the Evidence- Bipolar Disorder and Schizophrenia (AACAP 2025) - "FDA approval will also be part of the metric in helping to determine recommendations. Multiple studies are available that are funded by the NIH and FDA for psychosis (primarily schizophrenia) that show high levels of evidence, ie, grades 1A and 1B for benefit with tolerable side effects including newer medications such as lurasidone. Other medications have good efficacy but higher side-effect burdens such as clozapine. Finally, some medications have inadequate separation from placebo and are not approved, such as ziprasidone and asenapine... The field of psychopharmacology for bipolar and psychotic disorders has a number of completed controlled trials that contribute to the evidence base. Clinicians can use the GRADE system to recommend medications based on the balance of efficacy vs adverse event burden to obtain symptom control.BRD, PSY, PTA"

Bipolar Disorder • CNS Disorders • Depression • Mood Disorders • Pediatrics • Psychiatry • Schizophrenia

Efficacy and Tolerability of Seven Antipsychotic Drugs in Acutely Ill Patients With Schizophrenia: A Randomized, Multicenter, Assessor-Blinded Trial. (PubMed, Am J Psychiatry) - "Eligible inpatients 18-45 years of age with schizophrenia experiencing acute exacerbation were recruited and randomized to 6 weeks of monotherapy with one of seven antipsychotic drugs: olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, perphenazine, and haloperidol. This trial fills important knowledge gaps in acute antipsychotic treatment of schizophrenia. It confirms hierarchies in efficacy and side effects of antipsychotics from related evidence."

Journal • CNS Disorders • Psychiatry • Schizophrenia

Bipolar disorder in children, adolescents and young adults. Part 2. Therapeutic management. Recommendations under the patronage of the Executive Board of the Polish Psychiatric Association, National Consultants in the field of Psychiatry and National Consultants in Child and Adolescent Psychiatry. (PubMed, Psychiatr Pol) - "Lithium, aripiprazole, quetiapine, risperidone, olanzapine, asenapine, ziprasidone are recommended for the treatment of mania and mixed states. For the treatment of depressive episodes in bipolar disorder in children and adolescents, experts recommend lurasidone as monotherapy or olanzapine + fluoxetine as combination therapy. Although long-term treatment is a key aspect of bipolar disorder management in children and adolescents, consistent efficacy data are still lacking. Safety data indicate that the most commonly reported adverse reactions in children and adolescents treated with mood stabilizers are gastrointestinal and neurological adverse reactions, while the use of antipsychotics is mainly associated with weight gain and sedation."

Clinical guideline • Journal • Review • Anesthesia • Bipolar Disorder • CNS Disorders • Depression • Mood Disorders • Psychiatry

Glucose dysregulation signals in weight-neutral atypical antipsychotics: A pharmacovigilance-pharmacodynamic evaluation of FAERS data. (PubMed, J Affect Disord) - "Weight-neutral drugs such as ziprasidone, asenapine, lurasidone, and aripiprazole may be associated with glucose dysregulation, underscoring the need for vigilance when switching antipsychotics. This phenomenon might be attributable to their antagonistic effects on 5-HT2C receptors. However, given the exploratory nature of this study, these findings warrant further validation."

Adverse events • Journal • PK/PD data • CNS Disorders

Transferrin-Conjugated Chitosan Nanoparticles for Direct Nose-to-Brain Delivery of Ziprasidone: Pharmacokinetic and Pharmacodynamic Evaluation. (PubMed, Mol Pharm) - "Tf-NP also elicited a faster onset and sustained pharmacodynamic response. These data demonstrate that intranasal Tf-functionalized ZS nanoparticles significantly improve CNS targeting and bioavailability while mitigating systemic exposure, supporting their development as targeted therapeutics for neuropsychiatric disorders."

Journal • PK/PD data • CNS Disorders • Mental Retardation • Psychiatry

Real-world evidence analysis of oral and long-acting injectable antipsychotic treatment patterns among patients with schizophrenia in Germany (ECNP 2025) - "Olanzapine, risperidone, quetiapine and aripiprazole were the most commonly prescribed OAs (17.7%, 16.8%, 15.2% and 11.6%, respectively), while paliperidone, aripiprazole, flupentixol and risperidone were the most commonly prescribed LAIs (5.7%, 2.3%, 2.1% and 1.8%, respectively)...Among OAs, olanzapine (n=1457) and ziprasidone (n=100) had the lowest proportion of discontinuations (36% and 26%, respectively), with patients treated with olanzapine, ziprasidone and aripiprazole remaining on treatment the longest (163, 162 and 155 days, respectively)... In this dataset from Germany, LAIs are less commonly prescribed than OAs, despite demonstrating better adherence and discontinuation outcomes. These findings are consistent with previous literature [1]. However, within OAs, some molecules exhibit more favourable outcomes than others."

Clinical • HEOR • Real-world • Real-world evidence • CNS Disorders • Psychiatry • Schizophrenia

Hepatotoxicity associated with zotepine in a patient with schizophrenia spectrum disorder: a case report (ECNP 2025) - "[1,2] Case presentation: A 61-year-old female patient with a long-standing psychotic disorder, previously treated with risperidone (long-acting injectable) and ziprasidone, was brought to the emergency department (ED) by law enforcement due to disorganised behaviour in a public setting. In patients treated with zotepine, clinicians should consider routine LFT monitoring, especially when clinical deterioration is observed. Antipsychotic treatment plans must be tailored not only to psychiatric symptomatology but also to organ function, particularly in patients with limited treatment adherence and poor clinical insight. [4,5]"

Adverse events • Case report • Clinical • CNS Disorders • Psychiatry • Schizophrenia

Measurement of the Personal and Social Performance (PSP) Scale in patients treated with antipsychotics (ECNP 2025) - "Next in line were Ziprasidone (63.0), monthly Paliperidone (61.3), oral Olanzapine (60.9), total Paliperidone use (56.2), three-month Paliperidone (55.3), Risperidone (54.5), and six-month Paliperidone (50.7). At the lower end of our data, Clozapine showed the lowest PSP scores, with an average of 48.7 points... The results suggest that third-generation antipsychotics are associated with better functionality, as measured by the PSP Scale, compared to second-generation antipsychotics. This difference may reflect a more favorable profile of third-generation antipsychotics, with fewer sedative and metabolic side effects, which could contribute to improved quality of life and functioning in patients. It is also important to consider the individual response of patients and adherence to treatment.These findings reinforce our understanding of the superiority of partial agonists such as Aripiprazole and Cariprazine over dopamine antagonists in preserving and restoring patient..."

Clinical • CNS Disorders • Psychiatry • Schizophrenia

When aggression escalates: intermittent explosive disorder in an adolescent with autism spectrum disorder (ECNP 2025) - "In cases involving overlapping ASD and IED, a combination of behavioral therapy and pharmacological interventions — including second-generation antipsychotics (e.g., olanzapine, quetiapine, ziprasidone), GABAergic agents (amantadine, baclofen) — has been recommended to reduce episodic aggression [4]...The observed reduction in episodic aggression with a combination of aripiprazole and short-term olanzapine supports the potential utility of tailored antipsychotic regimens...Lumateperone: a novel agent for aggression. CNS Drugs. No conflict of interest"

Behavior Disorders • CNS Disorders • Mental Retardation • Psychiatry

Pharmacological fingerprints of polypharmacy with dopamine receptor partial agonists in combination with the "-dones" (risperidone, paliperidone, ziprasidone, iloperidone) (ECNP 2025) - "Methods We reviewed pharmacological properties of three DRPAs – aripiprazole (ARI), brexpiprazole (BRX), and cariprazine (CAR) – and four "-dones" – risperidone (RIS), paliperidone (PAL), ziprasidone (ZIP) and iloperidone (ILO).(2-4) Results DRPAs' half-life is longer (3 days-1 week) than that of the -dones' (7-33 hours)...Metabolic pathways are mostly shared: CYP3A4 and 2D6, thus, even more attention should be paid to avoiding the co-administration of enzyme inhibitors (e.g., carbamazepine, grapefruit juice, fluoxetine)...A generally positive advantage as seen in case of DRPA+pines (clozapine, olanzapine, quetiapine) cannot be postulated for DRPA+dones, however, the neuroreceptor complementarity is most clearcut with CAR vs. ARI & BRX. Keywords: dopamine receptor partial agonists, antipsychotic polypharmacy, combination, receptor profile"

Combination therapy • CNS Disorders • Psychiatry • Schizophrenia • CYP3A4

Molecular determinants of the different metabolic adverse effects of antipsychotics (ECNP 2025) - "The olanzapine-samidorphan combination is presently the sole instance of co-treatment aimed at mitigating weight gain; nonetheless, the product information indicates that fasting triglycerides are elevated with olanzapine, even when samidorphan is administered concurrently.This example underscores that the processes underlying the unfavorable metabolic effects of antipsychotics are poorly understood, a knowledge gap we aim to address...Their primary targets are the enzymes that synthesize cholesterol, the lysosomal apparatus that processes endocited cholesterol, and the resulting modifications to gene transcription and metabolic control, which involve SREBPs, AMPK, and more.We have identified significant variations in the metabolic adverse action of three antipsychotics—olanzapine (high risk), risperidone (mid risk), and ziprasidone (low risk)—that may account for their varying effects on patients...While studying these antipsychotics, we found that co-treatment with..."

Adverse events • CNS Disorders

Venetoclax as a cytoreduction therapy option for acute promyelocytic leukemia in newly diagnosed adult patients: a case report of a 35-year-old female with schizophrenia. (PubMed, Front Oncol) - "The patient was admitted with myocardial ischemia, the cardiac ultrasound indicating left ventricular ejection fractions (EF) of 44%, a 17-year history of schizophrenia, treated with ziprasidone, lorazepam, and clozapine. She developed differentiation syndrome (DS) shortly after receiving All-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) and experienced heart arrest. In the occurrence of DS, this young female encountered numerous therapeutic conundrums, including cytoreduction of hydroxyurea being ineffective, the potential psychological worsening caused by dexamethasone use, and the cardiotoxicity of anthracyclines...Tumor lysis syndrome (TLS) did not develop since the patient received good supportive treatment. For newly diagnosed adult patients with APL who are unresponsive to traditional cytoreduction therapy, venetoclax can be an effective option."

Journal • Acute Promyelocytic Leukemia • Cardiovascular • CNS Disorders • Hematological Malignancies • Leukemia • Myocardial Ischemia • Oncology • Pediatrics • Psychiatry • Schizophrenia

Estimating and Reducing the Cardiovascular Risk of Patients With Schizophrenia Drugs From Lipid Measures and Ischemic Electrocardiographic Changes (clinicaltrials.gov) - P3 | N=48 | Terminated | Sponsor: Northwestern University | N=250 ➔ 48

Enrollment change • Bipolar Disorder • Cardiovascular • CNS Disorders • Mood Disorders • Psychiatry • Schizophrenia

Association of Atypical Antipsychotics With Lipid Abnormalities in Adult Patients With Schizophrenia: A Scoping Review. (PubMed, Neuropsychopharmacol Rep) - "The review shows significant associations between specific AAs and lipid abnormalities, particularly with clozapine and olanzapine. Biomarkers and genetic polymorphisms offer promising avenues for monitoring and personalized treatment. Evidence for certain AAs, such as amisulpride, paliperidone, and ziprasidone, remains sparse, highlighting the need for further targeted research. These findings support informed prescribing and the development of predictive tools to mitigate metabolic risks in the treatment of schizophrenia."

Journal • Review • CNS Disorders • Dyslipidemia • Psychiatry • Schizophrenia • APOA1 • IGFBP2

Association of Antipsychotic Dose with Surrogate Efficacy and Safety Outcomes in Hospitalized Older Adults: A Retrospective Cohort Study. (PubMed, Drugs Aging) - "Low- and high-dose antipsychotics demonstrated similar short-term efficacy, but higher doses may carry increased risk of adverse events in hospitalized older adults. Clinicians should prioritize low-dose regimens and evaluate the necessity of antipsychotic use in this vulnerable population."

Journal • Retrospective data • CNS Disorders • Critical care • Infectious Disease • Palliative care • Pneumonia • Psychiatry • Respiratory Diseases

Ziprasidone-Induced Tardive Dyskinesia Unmasked by Lithium Discontinuation: A Case Report (ISBD 2025) - "The emergence of depressive and anxiety symptoms, including insomnia, and the presence of psychosocial stressors, led to the addition of divalproex and lorazepam. The development of TD in this patient highlights the need to keep in mind the risk of TD even with atypical antipsychotics, to continue research on the potential protective effects of lithium and to advance the widespread availability of VMAT2 inhibitors for TD."

Case report • Clinical • Bipolar Disorder • CNS Disorders • Depression • Insomnia • Mood Disorders • Movement Disorders • Psychiatry • Sleep Disorder