For Schizophrenia, Combining Ziprasidone and Olanzapine May Be Better than Switching
Combining ziprasidone and olanzapine at the outset of schizophrenia treatment is better than switching from olanzapine to ziprasidone for lessening psychotic symptoms, decreasing movement side effects, and avoiding increased risk of metabolic syndrome, a new study says.
The findings are published in the online Journal of Psychiatric Research.
“Ziprasidone is often used with olanzapine in ‘switch’ and combination therapy,” researchers wrote, “but empirical evidence to support these strategies is limited.”
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In a 12-week open-label, assessor-blinded trial, 148 patients with schizophrenia spectrum disorders who were antipsychotic-free for at least 3 months were randomly assigned to 1 of 4 treatment regimens: ziprasidone monotherapy (49), olanzapine monotherapy (31), olanzapine for 4 weeks and then a switch to ziprasidone (35), or combination therapy with ziprasidone and olanzapine (33). Researchers looked at patients’ psychotic symptoms, abnormal involuntary movements, changes in weight gain, and metabolic measures throughout the study period.
For reducing overall psychotic and negative symptoms, ziprasidone-olanzapine combination therapy and switching from olanzapine to ziprasidone were comparable to olanzapine alone but better than ziprasidone alone at 8 and 12 weeks, the study found. However, olanzapine alone was linked with higher changes in weight gain, glucose, and lipid measures than the combination therapy and switching from olanzapine to ziprasidone.
Of all treatment regimens, the lowest overall incidence of adverse events and extrapyramidal symptoms occurred among patients assigned to ziprasidone-olanzapine combination therapy, leading researchers to conclude the combination approach was superior to switching from olanzapine to ziprasidone.
—Jolynn Tumolo
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