Neurology Medical News about agitation;agression;traumatic brain injury;pediatric population;ziprasidone

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Agitation and/or aggression after traumatic brain injury in the pediatric population treated with ziprasidone
Journal of Neurosurgery: Pediatrics, 06/05/09

Scott LK et al. – Results of a limited pt series show ziprasidone as safe and effective in pediatric pts with closed head injuries who develop agitation and/or aggression in immediately postinjury. Ziprasidone consistently lowered Riker Sedation-Agitation Scale (SAS) scores in all age groups, with minimal dose adjustments, brief duration of therapy, and no adverse events. A prospective trial of ziprasidone in this population is warranted.

Methods

Report of ziprasidone to treat posttraumatic brain injury (post-TBI) agitation in 20 consecutive pediatric pts
Secondary aim: to establish an age-specific dosage and identify possible drug side effects
Case series study of all TBI pts presenting over 18-mo period to pediatric intensive care unit who later developed agitation and/or aggression
Ziprasidone treatment as sole intervention
Recording of pre- and post-treatment SAS scores and demographic data
Children stratified into 4 age groups: < 2 yrs (Group 1), 2–6 yrs (Group 2), 7–12 yrs (Group 3), and ≥ 13 yrs (Group 4)

Results

Ziprasidone for 20 children with agitation and/or aggression during immediate recovery period from TBI
Median pt age: 8 yrs (range 9 mo–17 yrs)
SAS score, before and 24 hrs after ziprasidone initiation, showed significant reduction after initiation
Initial dose for Groups 1–4: 1.7, 0.9, 0.7, and 0.6 mg/kg, respectively, with final doses of 1.8, 1.5, 1.7, and 0.07 mg/kg, respectively
Duration of therapy for Groups 1–4: 5, 8, 6, and 3 days, respectively
Continuous cardiac and blood-pressure monitoring for all pts
No adverse events in any pt age group

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