Hospital Dr Rodríguez Lafora, Department of Psychiatry, Cra de Colmenar, Viejo Km 13.8, 28049 Madrid, Spain.
Expert Opin Pharmacother. 2011 Oct;12(14):2245-63. doi: 10.1517/14656566.2011.605787. Epub 2011 Jul 30.
Limited information is available on the clinical issues and strategies for optimal clinical usage of ziprasidone in the treatment of adult patients with acute manic or mixed episodes of bipolar disorder.
To address those issues, information from clinical trials addressing the efficacy and tolerability of ziprasidone in acute bipolar mania was reviewed and supplemented with the input from an expert faculty of European psychiatrists with extensive experience in treating patients with bipolar mania, both in clinical trials and in everyday clinical practice.
Effective use of oral ziprasidone in the treatment of acute bipolar mania requires rapid titration to doses in the range 120 - 160 mg/day and administration with meals of ≥ 500 kcal. As in the clinical trials, temporary short-term use of benzodiazepines (in particular lorazepam for agitation or temazepam for insomnia) could be advisable. Available evidence from randomized clinical trials in combination with clinical experience supports the use of ziprasidone as one of the first-line effective and safe treatments for acute manic or mixed episodes associated with bipolar I disorder.
有关齐拉西酮在治疗成人双相情感障碍急性躁狂或混合发作患者中的临床问题和最佳临床应用策略方面的信息有限。
为了解决这些问题，我们回顾了评估齐拉西酮在急性双相躁狂症中的疗效和耐受性的临床试验资料，并补充了来自在临床试验和日常临床实践中均具有丰富治疗双相躁狂症经验的欧洲精神科专家小组的意见。
在治疗急性双相躁狂症时，有效使用口服齐拉西酮需要快速滴定至 120-160mg/天的剂量，并随餐服用≥500 千卡。与临床试验一样，临时短期使用苯二氮䓬类药物（特别是用于激越的劳拉西泮或用于失眠的替马西泮）可能是明智的。来自随机临床试验的现有证据以及临床经验支持将齐拉西酮作为治疗与双相 I 障碍相关的急性躁狂或混合发作的一线有效且安全的治疗方法之一。
