The Webinar portion of the PrimeE-B program has been completed. Thank you for your participation.

This 2-part Webinar discusses management and treatment of bipolar disorder in patients shared by primary care and mental health care professionals. Each part is presented by 2 faculty members who represent both primary care's and psychiatry's points of view.

Program Description:

• Esteemed faculty representing primary care and psychiatry will copresent each Webinar
• Each live Webinar is scheduled to be approximately 45 minutes long and will include a lecture followed by an interactive Q&A
• Five additional Webinars will be offered following each live presentation; they will consist of a tape of the original presentation followed by live Q&A
• During all scheduled Webinars, registered participants will be able to interact with the presenters
• For those who are unable to participate in a scheduled event, the audio of the presentation (minus Q&A) will be available on demand for 24 hours after each Webinar

Target Audience:

This activity is designed for primary care physicians, psychiatric clinicians, physician assistants, nurse practitioners, and psychiatric nurses who are interested in learning more about the collaborative management of their bipolar patients with manic and mixed symptomatology.

Presentation Objectives:

• Provide information that can make a difference in increasing awareness of bipolar disorder and how it presents in primary care settings
• Give practical information on monitoring metabolic disturbances in psychiatric patients being treated for manic and mixed episodes of bipolar disorder
• Offer insight into ways for primary care providers and mental health providers to collaborate to optimize outcomes for shared patients²

1. Garber AJ, Johnson DL, Krauss RM, et al. J Clin Psychiatry 2005;66:790-798.
2. Griswold KS, Pessar LF. Am Fam Physician 2000;62:1343-1353, 1357-1358.

Please click here to see ziprasidone full prescribing information. By clicking this link, you selected to read information for medical professionals.

Ziprasidone is indicated for the treatment of acute manic or mixed episodes associated with bipolar disorders with or without psychotic symptoms.

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Ziprasidone is not approved for the treatment of patients with dementia-related psychosis.

Ziprasidone is contraindicated in patients with a known history of QT prolongation, recent acute myocardial infarction, or uncompensated heart failure, and should not be used with other QT-prolonging drugs. Ziprasidone has a greater capacity to prolong the QT_c interval than several antipsychotics. In some drugs, QT prolongation has been associated with torsade de pointes, a potentially fatal arrhythmia. In many cases this would lead to the conclusion that other drugs should be tried first.

As with all antipsychotic medications, a rare and potentially fatal condition known as neuroleptic malignant syndrome (NMS) has been reported with ziprasidone. NMS can cause hyperpyrexia, muscle rigidity, diaphoresis, tachycardia, irregular pulse or blood pressure, cardiac dysrhythmia, and altered mental status. If signs and symptoms appear, immediate discontinuation, treatment, and monitoring are recommended.

Prescribing should be consistent with the need to minimize tardive dyskinesia (TD), a potentially irreversible dose- and duration-dependent syndrome. If signs and symptoms appear, discontinuation should be considered since TD may remit partially or completely.

Hyperglycemia-related adverse events, sometimes serious, have been reported in patients treated with atypical antipsychotics. There have been few reports of hyperglycemia or diabetes in patients treated with ziprasidone, and it is not known if ziprasidone is associated with these events. Patients treated with an atypical antipsychotic should be monitored for symptoms of hyperglycemia.

Precautions include the risk of rash, orthostatic hypotension, and seizures.

The most common adverse events associated with ziprasidone in bipolar mania were somnolence, extrapyramidal symptoms, dizziness, akathisia, and abnormal vision.

In short-term schizophrenia trials, the most commonly observed adverse events associated with ziprasidone at an incidence of
5% and at least twice the rate of placebo were somnolence and respiratory tract infection.

In short-term schizophrenia clinical trials, 10% of ziprasidone-treated patients experienced a weight gain of 7% of body weight vs 4% for placebo.