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Pathway Description
Ziprasidone Dopamine Antagonist Action Pathway
Homo sapiens
Drug Action Pathway
Ziprasidone is an atypical antipsychotic used to treat schizophrenia, bipolar mania, and acute agitation in schizophrenic patients. It also indicated improvement on the manic syndrome subscale that measures symptoms of mania such as mood, insomnia, excessive energy and activity, and overall behavior and ideation. Ziprasidone is also used as off-labeled for monotherapy in acute hypomania, monotherapy as maintenance treatment for adult patients with bipolar I disorder, hyperactivity treatment, and for the treatment of delirium in the ICU. Ziprasidone presents in both oral capsule and intramuscular injection formulations. Ziprasidone is an atypical antipsychotic that has a binding affinity for dopaminergic (DA), serotonergic (5HT), adrenergic (a1), and histaminergic (HA) receptors. Regarding treatment for schizophrenia, antagonism of the dopamine (D2) receptor in the mesolimbic pathway has proven efficacious in diminishing positive symptoms, whereas the antagonism of the 5HT2A receptor in the mesocortical pathway has demonstrated reduction of negative symptoms of psychosis. Its efficacy and mechanism of action for treating bipolar disorder are unknown. The antagonization of both histaminergic and adrenergic (a1) receptors can induce somnolence and orthostatic hypotension.
References
Ziprasidone Dopamine Antagonist Pathway References
Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M: DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. doi: 10.1093/nar/gkx1037.
Pubmed: 29126136
Younce JR, Davis AA, Black KJ: A Systematic Review and Case Series of Ziprasidone for Psychosis in Parkinson's Disease. J Parkinsons Dis. 2019;9(1):63-71. doi: 10.3233/JPD-181448.
Pubmed: 30475775
Shim IH, Bahk WM, Woo YS, Yoon BH: Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review. Clin Psychopharmacol Neurosci. 2018 Nov 30;16(4):376-382. doi: 10.9758/cpn.2018.16.4.376.
Pubmed: 30466209
Macaluso M, Preskorn SH: Knowledge of the Pharmacology of Antidepressants and Antipsychotics Yields Results Comparable With Pharmacogenetic Testing. J Psychiatr Pract. 2018 Nov;24(6):416-419. doi: 10.1097/PRA.0000000000000345.
Pubmed: 30395549
Sabe M, Zhao N, Crippa A, Kaiser S: Antipsychotics for negative and positive symptoms of schizophrenia: dose-response meta-analysis of randomized controlled acute phase trials. NPJ Schizophr. 2021 Sep 13;7(1):43. doi: 10.1038/s41537-021-00171-2.
Pubmed: 34518532
Bouchette D, Fariba KA, Marwaha R: Ziprasidone.
Pubmed: 28846230
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