{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:39:36Z","timestamp":1753889976356,"version":"3.41.2"},"reference-count":18,"publisher":"IMR Press","issue":"2","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Alpha Psychiatry"],"abstract":"<jats:p>Objective: Agitation represents a serious and prevalent symptomatology within acute schizophrenia. This study aims to conduct a nuanced comparison of the efficacy and safety profiles of intramuscular (IM) ziprasidone versus IM haloperidol in the management of agitation among patients with acute schizophrenia. Methods: This investigation was structured as a randomized, 3-day study, utilizing flexible dosing strategies. It included 69 patients diagnosed with schizophrenia, who were randomly allocated to receive either IM ziprasidone (n = 35, 20 to 40 mg\/day) or IM haloperidol (n = 34, 5 to 10 mg\/day). The primary endpoints included comparative analyses of the change in Positive and Negative Syndrome Scale (PANSS) total scores and Positive and Negative Syndrome Scale Excited Component (PANSS-EC) scores from baseline to study completion across the two groups. Results: At baseline, there were no significant differences between the IM ziprasidone and haloperidol groups. Both treatments led to significant reductions in PANSS-EC total scores (haloperidol, p = 0.001; ziprasidone, p = 0.001) and PANSS total scores (haloperidol, p = 0.001; ziprasidone, p = 0.001) from baseline to study endpoint. Nevertheless, no significant difference was observed between the two groups in terms of changes in PANSS-EC scores (p = 0.312) and PANSS total scores (p = 0.159) from baseline to endpoint. The haloperidol group exhibited a higher incidence of adverse events compared with the ziprasidone group, reaching statistical significance (p = 0.027). Conclusions: Our findings indicate that both medications are equally effective in controlling agitation symptoms. However, ziprasidone exhibited superior characteristics in safety and tolerability, particularly in reducing the incidence of extrapyramidal symptoms. Clinical Trial Registration: The study was registered at https:\/\/www.chictr.org.cn\/showproj.html?proj=246996, registration number: ChiCTR2500100002, date of registration: 1 April 2025.<\/jats:p>","DOI":"10.31083\/ap40032","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T10:59:27Z","timestamp":1745924367000},"source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Ziprasidone Injection vs Haloperidol Injection for Agitation in Patients with Acute Schizophrenia"],"prefix":"10.31083","volume":"26","author":[{"given":"Sufang","family":"Qi","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjie","family":"Li","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limin","family":"Yang","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangwei","family":"Sun","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinming","family":"Li","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Liu","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhicheng","family":"Xue","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Zhang","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8024-8046","authenticated-orcid":true,"given":"Guanglei","family":"Xun","sequence":"first","affiliation":[{"name":"Shandong Mental Health Center, Shandong University, 250014 Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Hu H, Liu F, Liu L, Mei Y, Xie B, Shao Y, et al. Smaller amygdala subnuclei volume in schizophrenia patients with violent behaviors. Brain Imaging and Behavior. 2023; 17: 11\u201317.","DOI":"10.1007\/s11682-022-00736-4."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Chen Q, Zhou J. Aggression of Chinese inpatients with schizophrenia: a systematic literature review. Journal of Central South University. Medical Sciences. 2012; 37: 752\u2013756.  (In Chinese)","DOI":"10.3969\/j.issn.1672-7347.2012.07.019."},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"San L, Marksteiner J, Zwanzger P, Figuero MA, Romero FT, Kyropoulos G, et al. State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study. Clinical Practice and Epidemiology in Mental Health. 2016; 12: 75\u201386.","DOI":"10.2174\/1745017901612010075."},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Lindenmayer JP. The pathophysiology of agitation. The Journal of Clinical Psychiatry. 2000; 61: 5\u201310.","DOI":"10.4088\/JCP.v61n0207"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Martel ML, Driver BE, Miner JR, Biros MH, Cole JB. Randomized Double-blind Trial of Intramuscular Droperidol, Ziprasidone, and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. Academic Emergency Medicine. 2021; 28: 421\u2013434.","DOI":"10.1111\/acem.14124."},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Su L, Lu Z, Shi S, Xu Y. Ziprasidone, haloperidol and clonazepam intramuscular administration in the treatment of agitation symptoms in Chinese patients with schizophrenia: A network meta-analysis. General Psychiatry. 2018; 31: e000016.","DOI":"10.1136\/gpsych-2018-000016."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Klein LR, Driver BE, Miner JR, Martel ML, Hessel M, Collins JD, et al. 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Aripiprazole versus other atypical antipsychotics for schizophrenia. The Cochrane Database of Systematic Reviews. 2009; CD006569.","DOI":"10.1002\/14651858.CD006569.pub3."},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Suzuki H, Gen K, Takahashi Y. A naturalistic comparison of the efficacy and safety of intramuscular olanzapine and intramuscular haloperidol in agitated elderly patients with schizophrenia. Therapeutic Advances in Psychopharmacology. 2013; 3: 314\u2013321.","DOI":"10.1177\/2045125313496113."},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Zimbroff DL, Allen MH, Battaglia J, Citrome L, Fishkind A, Francis A, et al. Best clinical practice with ziprasidone IM: update after 2 years of experience. CNS Spectrums. 2005; 10: 1\u201315.","DOI":"10.1017\/s1092852900025487."},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Roberts J, Gracia Canales A, Blanthorn-Hazell S, Craciun Boldeanu A, Judge D. 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Child and Adolescent Psychiatry and Mental Health. 2009; 3: 9.","DOI":"10.1186\/1753-2000-3-9."}],"container-title":["Alpha Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/AP\/26\/2\/10.31083\/AP40032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T11:01:04Z","timestamp":1745924464000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/AP\/26\/2\/10.31083\/AP40032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"alternative-id":["S2757-8038(25)02027-0"],"URL":"https:\/\/doi.org\/10.31083\/ap40032","relation":{},"ISSN":["2757-8038"],"issn-type":[{"type":"electronic","value":"2757-8038"}],"subject":[],"published":{"date-parts":[[2025,4,28]]},"article-number":"40032"}}