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Treatment with ziprasidone and changes in ECG in patient with schizophrenia

Objective: To present a case of prolongation of QTc interval in a paiient with schizophrenia during treatment with ziprasidone. Methods: Follow up of a patient with schizophrenia, who had prolongation of QTc interval during treatment with ziprasidone. Results: Patient, 34 years old, with diagnose of schizophrenia, according to DSM-IV TR criteria, was in psychiatric treatment for the past 10 years. She was treated with different antipsychotics, and with different treatment results. Treatment with some antipsychotics was discontinued because of side effects (leucopenia, extrapyramidal symptoms, changes in value of glucose). Treatment with ziprasidone was initiated during hospital treatment that was initiated after wors-ening in patient's mental condition—ideas of reference and auditory hallucinations dominated in clinical presentation. Before initiation of treatment with ziprasidone values of laboratory parameters were within reference range, and ECG was normal. Treatment with ziprasidone was initiated in daily dosage of 80 mg and daily dosage of ziprasidone was gradually increased to 160 mg. Also, patient was taking lorazepam and zolpidem in the evening as concomitant therapy. On the seventh day of treatment with ziprasidone the patient reported the feeling of pressure on her chest. She was examined by the specialist of internal medicine, and ECG was performed showing prolongation of QTc interval. The specialist of internal medicine found this result to be significant and related it to antipsychotic therapy. The treatment with ziprasidone was discontinued and control ECG performed several weeks after that showed normal value of QTc interval.Conclusion: Prolongation of QTc interval may occur during treatment with ziprasidone. .

ziprasidone; QT-c interval; schizophrenia; side effects

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