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Ziprasidone

QTc elongation

From Mr P. A. Hardy, MRPharmS

In his comprehensive review of ziprasidone (PJ, March 24, p396), David Taylor mentions electrocardiogram changes that have been seen with this drug. Pharmacists might be interested in a further study on ziprasidone and QTc elongation which has been reported in truncated form as part of a transcript of a meeting. It is available for download here as a 640K RTF (rich text format) file. To the best of my knowledge this study has not reached the peer-reviewed literature.

In the study, 183 patients with normal ECGs and psychotic disorders were withdrawn from current medication and treated with one of six drugs: ziprasidone, haloperidol, olanzapine, quetiapine, risperidone or thioridazine. Thioridazine had the largest effect on QTc interval, followed by ziprasidone. Thioridazine increased the QTc interval on average by 36ms, whereas for ziprasidone the figure was 10 to 20ms.

The study was requested by the Food and Drug Administration as part of the licensing process in the US, and it seems that warnings about this effect might appear in the summary of product characteristics for the product.

Paul Hardy
Wakefield, West Yorkshire

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