Strategies for successful clinical management of schizophrenia with ziprasidone

Importance of the field: This review addresses practical clinical issues related to the use of ziprasidone in the treatment of schizophrenia using information from clinical trials, unpublished data, manufacturer’s information, and input from an expert faculty of European psychiatrists with extensive experience of the use of ziprasidone, both in clinical trials and in everyday clinical practice. Areas covered in this review: A Medline search of published data (1998 -- 2010) was carried out, together with a review of unpublished data and manufacturer’s information. In addition, expert opinion was sought from psychiatrists with extensive experience of ziprasidone in the treatment of schizophrenia in clinical settings across Europe. What the reader will gain: This review has been undertaken to determine how the information from clinical trials can be optimally translated into ‘real-life’ practice and to establish how a decade of experience with ziprasidone in clinical practice can inform its optimal use to maximize effectiveness and minimize side effects. Take home message: Effective use of ziprasidone in everyday clinical practice usually requires rapid titration to doses in the range of 120 -- 160 mg/day and administration with proper meals, thereby achieving the high levels of schizophrenia symptom control reported in clinical trials. Additional guidance is provided about effective management of side effects, and appropriate coadministration of benzodiazepines and other agents, to achieve desired outcomes.