No data on the use of the relatively new, atypical, antipsychotic ziprasidone as maintenance therapy in patients with bipolar disorder have been published. However, studies have shown that the drug has efficacy in acute mania, schizophrenia, and schizoaffective disorder. Ziprasidone has been associated with QTc prolongation.

Strengths:

• Less weight gain, hormonal changes, and EPS compared with other atypical antipsychotics.
• Proven efficacy in the acute treatment of mania.

Weaknesses:

• Has been associated with QTc prolongation.
• Data on use for maintenance therapy are limited.
• There is a perception that ziprasidone may trigger affective switching.

Guidelines