Efficacy of Ziprasidone in Controlling Agitation during Post-Traumatic Amnesia

Objectives: to provide our initial experience with ziprasidone in the management of behaviour problems of patients with traumatic brain injury (TBI) during the period of post-traumatic amnesia (PTA). Patients: Five patients with a mean age of 26.8 ± 9.8 years who had suffered a severe TBI (Glasgow Coma Scale score < 8; length of coma: 16 ± 7.1 days; and length of PTA: 62.4 ± 14.8 days) were included in the study. Agitation was assessed by the Agitated Behaviour Scale (ABS) prior to the administration of ziprasidone, after two weeks of initiating treatment and at the moment of discontinuing ziprasidone. Results: ABS Total score decreased from 27.2 ± 3 to 18 ± 1.2 after two weeks of treatment. The same decrease was also noticed in each one of the subscales (dishinhibition, aggressiveness and lability). Mean dose of the drug was 52.8 ± 27.11 mg/day (range: 20–80 mg), with the highest dose ranging between 40 and 80 mg (64 ± 21.9 mg). Maximum period of administration of ziprasidone was 48.2 ± 14.8 days (range: 35–68 days). No clinical or electrocardiographic side effects were reported. Conclusion: This study shows the efficacy of ziprasidone in controlling agitation during the PTA period. Despite the small size of our sample, ziprasidone reduced symptoms of agitation quickly and with good tolerability, safety and no side effects.