Ziprasidone for Agitation or Psychosis in Dementia: Four Cases

Objective: These case reports examine the potential efficacy and safety of ziprasidone for the treatment of agitation or psychosis in dementia. Method: The authors performed a retrospective chart review of three patients with DSM-IV diagnoses of dementia, treated with ziprasidone for agitation/psychosis on an academic psychiatric inpatient unit in 2002–2003. In addition, these three case reports are supplemented by a clinical report of the first outpatient with DSM-IV diagnosis of dementia completing a prospective open-label six-week study in 2004 evaluating the use of oral ziprasidone for agitation/psychosis in dementia. Qualitative descriptions of clinical improvement provide outcome data for these case reports. Results: Four patients with dementia with agitation/psychosis experienced marked behavioral improvement after receiving oral doses of ziprasidone (20–160 mg/day), without any evidence of problematic cardiac or other side-effects. Two of the four patients had final EKGs and both of these patients demonstrated no change of QTc interval after administration of ziprasidone. Conclusions: These case reports suggest that oral ziprasidone may be an effective and safe medication for the treatment of agitation or psychosis in patients with dementia.