February 2007

Acupuncture for Depression: Missing the Point
Depression-specific acupuncture was no better than nonspecific acupuncture for patients with major depression.

Adjunctive Galantamine in Schizophrenia
Galantamine (formerly Reminyl, currently Razadyne) added to risperidone (Risperdal) treatment for schizophrenia patients offered some benefits.

Adverse Effects of Erectile Dysfunction Drugs
Drugs for erectile dysfunction, such as sildenafil (Viagra) and vardenafil (Levitra), may worsen sleep apnea and can cause seizures.

Deep brain stimulation decreased obsessive compulsive symptoms in 10 patients.

Clozapine for Treatment-Resistant Schizophrenia
Clozapine (Clozaril and others) was superior to other second-generation antipsychotics for treatment-resistant patients with schizophrenia.

In Brief
Rasagiline Approved for Treatment of Parkinson's Disease; Paliperidone Approved for Treatment of Schizophrenia; PCOS Reversed When Valproate Discontinued.

Antipsychotics and New MIs
A large study suggests that antipsychotic drugs do not increase the risk of a new myocardial infarction (heart attack).

Take Ziprasidone with Food
Adequate absorption of ziprasidone is promoted by taking it with a meal that contains at least 30% fat.

Take Ziprasidone with Food

February 2007

Product labeling for the antipsychotic ziprasidone (Geodon) calls for it to be taken with a meal. Ziprasidone shows increased bioavailability with food and, conversely, levels are lower when it is taken on an empty stomach. Preskorn and others report on two pharmacokinetic studies involving ziprasidone and food.1

The effects of different meals and their content on the bioavailability of ziprasidone was examined in 22 healthy subjects. For ziprasidone, 20 to 80 mg, coadministered food substantially increased absorption. A meal containing 30% fat approximately doubled ziprasidone bioavailability, and a 60% fat meal increased it slightly more. This suggests that for adequate absorption of ziprasidone and, presumably, adequate therapeutic effects, it must be administered with a lipid-containing meal. A light carbohydrate snack (eg, crackers and juice) is likely to be insufficient.

1Preskorn S, Lombardo I, Alderman J, Wilner K, Miceli J: Effect of food on absorption of ziprasidone. Paper presented at the 45th annual meeting of the American College of Neuropsychopharmacology, Hollywood, FL, December 3-7, 2006.