Section - CAP Smart Takes

03. Efficacy, Safety, and Tolerability of Ziprasidone in Youth

Published on March 1, 2023 Certification expiration date: March 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Ziprasidone was found to be safe and well tolerated, with no new safety signals and no significant difference from placebo in terms of weight gain or metabolic abnormalities in youth with bipolar I disorder in the manic phase.
Ziprasidone appears to have considerable promise in pediatric bipolar disorder both from a safety and effectiveness profile.

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Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we will look at the efficacy, safety, and tolerability of ziprasidone in children and adolescents with bipolar I disorder in the manic phase. This is a randomized placebo-controlled replication study of an earlier study by Findling and colleagues that found ziprasidone to be safe and effective in pediatric bipolar disorder. Moreover, there is a lot to like about this study. They studied 171 pediatric patients with bipolar disorder 10–17 years of age. They conducted a 4-week double-blind, placebo-controlled study. Ziprasidone was dosed flexibly between 20 mg–80 mg/day vs placebo. And they found that ziprasidone was effective in children and adolescents with bipolar I disorder in the manic episode, which replicated the earlier findings by Findling and colleagues. I think what was even more noteworthy was the fact that ziprasidone was safe and well tolerated.

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04. Ketamine for Adolescent Depression

Learning Objectives:

Recognize that the neuropeptides targeting social impairment in autism spectrum disorder—oxytocin and vasopressin—do not appear to be effective.
Conclude that although depression and anxiety are listed as common side effects in youth treated with ADHD medications, few studies report depression or anxiety as an outcome or side effect.
Acknowledge that ziprasidone use may be associated with less risk for weight gain and metabolic abnormalities, such as diabetes, than other SGAs medications.
Identify the pharmacologic action and potential role of ketamine in treating adolescent depression.
Identify the impact of antipsychotics on prolactin levels in children and adolescents.

Original Release Date: March 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: March 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Lorena Rodriguez, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.