, Volume 178, Issue 4, pp 514–523

Ziprasidone and haloperidol in the treatment of acute exacerbation of schizophrenia and schizoaffective disorder: comparison of intramuscular and oral formulations in a 6-week, randomized, blinded-assessment study


    • Department of PsychiatrySterkfontein Hospital
  • Jeorg Walden
    • Universitätsklinik für Psychiatrie und Psychosomatik
  • Isma Benattia
    • Pfizer Inc
  • Cynthia O. Siu
    • Pfizer Inc
  • Steven J. Romano
    • Pfizer Inc
Original Investigation

DOI: 10.1007/s00213-004-2082-5

Cite this article as:
Brook, S., Walden, J., Benattia, I. et al. Psychopharmacology (2005) 178: 514. doi:10.1007/s00213-004-2082-5



Conventional intramuscular (IM) antipsychotics used in managing acute exacerbation of schizophrenia are associated with side effects such as acute dystonia.


To compare the efficacy and tolerability of sequential IM/oral ziprasidone with haloperidol in acute exacerbation of schizophrenia or schizoaffective disorder.


In a 6-week, multicenter, parallel-group, flexibly dosed study, patients were randomized to ziprasidone (IM up to 3 days, then oral 40–80 mg, b.i.d.) or haloperidol (IM up to 3 days, then oral 5–20 mg/day). Assessments were rater-blinded.


At the end of IM treatment, patients receiving ziprasidone (n=427) showed significantly improved Brief Psychiatric Rating Scale Total (BPRS total) scores compared with those receiving haloperidol (n=138) [least-squares (LS) mean change −6.14 for ziprasidone versus −4.13 for haloperidol, P<0.0018]. At endpoint, there were no significant between-group differences in BPRS total scores. There was a significantly greater improvement in BPRS negative subscale scores in ziprasidone-treated patients, both at the end of IM treatment (LS mean change −1.15 for ziprasidone and −0.28 for haloperidol, P<0.0001) and at study endpoint (LS mean change −2.94 for ziprasidone and −2.24 for haloperidol, P<0.0001). Haloperidol-treated patients exhibited significantly greater increases in Extrapyramidal Symptom Rating Scale at end of IM treatment and at endpoint (P<0.0001). They also had significantly higher ratings on the Barnes Akathisia Scale (P<0.0001) and the Movement Disorder Burden Score (P<0.005), as well as higher incidences of movement disorder-related adverse events.


Sequential IM and oral ziprasidone offers important efficacy and tolerability advantages over haloperidol in acute schizophrenia.


Acute schizophreniaAntipsychoticsHaloperidolSchizophreniaSequential intramuscular/oralZiprasidone

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© Springer-Verlag 2005