Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
PREGNANCY: Ziprasidone has not been studied in
pregnant women, but studies in animals have shown that ziprasidone causes birth defects. Nevertheless, a physician may chose to use ziprasidone if he/she feels that its benefits outweigh this potential concern.
NURSING MOTHERS: It is not known if ziprasidone is excreted in
breast milk. Since most drugs are excreted in breast milk, it is recommended that women receiving ziprasidone should not breast feed their infants.
SIDE EFFECTS: Some of the most common side effects associated with ziprasidone are feeling unusually tired (1 in 7 patients), nausea (1 in 10), constipation (1 in 11), dizziness (1 in 12), restlessness (1 in 12), diarrhea (1 in 20), rash (1 in 20), and a condition with abnormal muscle movements, including tremor, shuffling, and uncontrollable movements (1 in 20).
There is a slight risk (1 in 1500 patients) that ziprasidone by itself could significantly increase the QT interval. There is an even smaller risk (1 in 4000 patients) that it could cause a potentially serious change in the rhythm of the heart.
Ziprasidone causes orthostatic hypotension,
a drop in blood pressure upon rising that can cause dizziness or lightheadedness. The risk is about 1 in 200 patients.
Ziprasidone frequently causes tiredness (1 in 7 patients). Therefore, care should be exercised in any activity requiring mental alertness, such as operating a motor vehicle (including automobiles) or operating hazardous machinery. Less common side effects include seizures (1 in 250 patients).
As with other antipsychotics, long-term use of ziprasidone may lead to a potentially irreversible condition called tardive dyskinesia (involuntary movements of the jaw, lips, and tongue).
A potentially fatal complex referred to as neuroleptic malignant syndrome (NMS) has been reported with other anti-psychotic drugs. Patients who develop NMS may have high fevers, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid heart rate, excessive sweating, and heart arrhythmias.
Although there is no clear link between ziprasidone and diabetes, patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.