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Title: Enhanced ziprasidone combination therapy effectiveness in obese compared to nonobese patients with bipolar disorder
Authors: Shefali Miller
Pichai Ittasakul
Po W. Wang
Shelley J. Hill
Meredith E. Childers
Natalie Rasgon
Terence A. Ketter
Stanford University School of Medicine
Mahidol University
Keywords: Medicine
Issue Date: 1-Dec-2012
Citation: Journal of Clinical Psychopharmacology. Vol.32, No.6 (2012), 814-819
Abstract: OBJECTIVE: To assess longer-term ziprasidone effectiveness in obese and non-obese patients with bipolar disorder (BD). METHODS: Outpatients assessed with the Systematic Treatment Enhancement Program for BD Affective Disorders Evaluation and monitored with the Systematic Treatment Enhancement Program for BD Clinical Monitoring Form received open ziprasidone. RESULTS: Eighty-two patients (39 patients with BD I, 39 patients with BD II, and 4 patients with BD not otherwise specified; mean age, 41.1 years; females, 78.0%; obese, 48.8%) received ziprasidone combined with an average of 3.6 (in 74.4% at least 3) other prescription psychotropics and 1.2 prescription nonpsychotropics. Mean (median) ziprasidone final dose and duration were 134.3 (150) mg/d and 489 (199.5) days, respectively. Ziprasidone yielded in obese compared to nonobese patients less discontinuation (42.5% vs 71.4%, P = 0.01), albeit with a higher rate of addition of subsequent psychotropic medication (62.5% vs 35.7%, P = 0.03). Moreover, obese compared to nonobese patients had a higher rate of shift to final-visit euthymia (27.5% vs 0.0%, P = 0.0002), and more weight loss (-20.7 lbs vs -0.6 lbs, P = 0.001), and obese (but not nonobese) patients had significant improvements in mean Clinical Global Impression-Severity of Illness (decreased 0.6 points; P = 0.03) and Global Assessment of Functioning (increased 3.3 points, P = 0.01) scores. Weight change correlated significantly with Global Assessment of Functioning change (P = 0.047) but not with Clinical Global Impression-Severity of Illness change. Limitations are small sample size and open-label, uncontrolled, observational design. CONCLUSION: Controlled and additional observational studies seem warranted to confirm our preliminary findings suggesting ziprasidone may be more effective in obese compared to nonobese patients with BD already receiving combination pharmacotherapy. Copyright © 2012 Lippincott Williams & Wilkins.
ISSN: 1533712X
Appears in Collections:Scopus 2011-2015

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