Şizofreni ve Şizoaffektif Bozukluk Akut alevlenmesi Olan Hastalarda Ziprasidon ile Risperidon'un Klinik Etkinlik, Ekstrapiramidal, Kardiyak ve Metabolik Yan Etkilerinin Karşılaştırılması.

Objective: Atypical antipsychotics have different clinical side effect profiles than typical antipsychotic agents. Also, side effect profiles of atypical antipsychotic agents are different from each other. As there are no proven significant clinical superiority among atypicals other than clozapine, clinicians make their atypical choice decisions according to side effect profiles. More clinical comparison studies are needed to discern the relative efficacy and side effect profiles of atypical antipsychotics. In this study we aimed to compare clinical efficacy and extrapyramidal, metabolic, and cardiac side effects of ziprasidone and risperidone in patients with acute exacerbation of schizophrenia and schizoaffective disorders. Method: A total 22 patients diagnosed with acute exacerbation of schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) were randomly assigned to receive ziprasidone 80-160 mg/day (n=11) or risperidone 4-8 mg/day (n=11) for 6 weeks. Positive and Negative Syndrome Scale total score (PANSS-T), positive symptoms subscale (PANSS-P) and negative symptoms subscale (PANSS-N) were used as efficacy measures. Abnormal Involuntary Movement Scale (AIMS), Simpson-Angus Scale (SAS), Barnes Akathisia Rating Scale (BARSI, were employed for movement disorder evaluations. Metabolic side effects were tested by checking laboratory tests, body weight, and body mass index measures. Electrocardiography and radionuclide ventriculography (Multigated Equilibrium Acquisition-MUGA scan) scan were used for cardiac side effect assessments. The data for twelwe patients, who complated the study were analyzed. The study was designed and conducted as a randomized open label trial. Results: Both antipsychotic drugs improved clinical symptoms significantly. The two treatment groups did not differ significantly in efficacy measures at the initial and endpoint assessments. There was statistically significant increase in parkinsonism symptoms on the 7th and 21st day evaluations in risperidone group according to SAS. Ziprasidone exhibited more beneficial effects on body weight and glucose levels. There was significant increase in prolactin levels on the 42th day lab result with risperidone. There was no difference betweeen the two drugs in terms of prolongation of QTc interval. But, ziprasidone induced more QTc prolongation on the 21st and 42th day ECGs according to baseline than risperidone. The two treatment groups did not differ significantly in left ventricular systolic and diastolic function measures at initial and endpoint assessments. Conclusions: Both drugs demonstrated significant clinical improvement. Risperidone had more extrapyramidal and endocrine side effects than ziprasidone. Ziprasidone had more QTc prolongation than the risperidone. MUGA results did not differ significantly between two groups. [ABSTRACT FROM AUTHOR]