Ziprasidone-associated Hypomania in Schizophrenia

Objective: Previous studies suggest that ziprasidone may result in hypomania or mania. However, most reported cases involved patients with mood disorders and only two schizophrenic patients developed mania during ziprasidone treatment. We describe a Taiwanese patient with schizophrenia who developed hypomanic symptoms following ziprasidone therapy. Case Report: A 37-year-old Taiwanese man who was hospitalized due to acute exacerbation of chronic schizophrenia was treated with 160mg per day of ziprasidone. Ten days after starting ziprasidone therapy, he developed hypomanic symptoms including expansive and euphoric mood, inflated self-esteem, decreased sleep desire, overtalkativeness, and hyperactivity. His mood symptoms resolved after switching from ziprasidone to risperidone therapy. However, his schizophrenic symptoms including persecutory delusions and auditory hallucinations relapsed after the switch in treatment. Due to the relapse of schizophrenic symptoms, his risperidone treatment was changed to olanzapine (20mg/d) and his schizophrenic symptoms were stabilized 12 days afterwards. Conclusion: This case suggests the need for awareness that hypomania or mania may occur as a result of ziprasidone treatment in schizophrenic patients.