Ziprasidone
| Evidence Level: L5 | Predicted Indications: 9 |
Table of Contents
Ziprasidone: Trichotillomania
One-Sentence Summary
Ziprasidone is an atypical antipsychotic that blocks dopamine D2 and serotonin 5-HT2A receptors. The TxGNN model predicts it may be useful for trichotillomania, with a score of 0.9983. The data compiled for this report contain no clinical trials and no publications that directly study this use, so the prediction rests on the model alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Trichotillomania |
| TxGNN Prediction Score | 0.9983 |
| Evidence Level | L5 |
| Australia Market Status | Listed on the PBS Schedule (1 of 1 items) – TGA (ARTG) registration status is not included in this data |
| Number of PBS Items | 1 (valid: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data for ziprasidone are not available in the data compiled for this report. Ziprasidone is generally described as an antagonist at dopamine D2 and serotonin 5-HT2A receptors.
Trichotillomania is a repetitive hair-pulling (grooming) behaviour. Dopamine and serotonin dysregulation is plausibly involved in such behaviours, which gives a theoretical reason to expect a receptor-blocking antipsychotic might have an effect. This link is hypothetical. No study in the compiled data tests ziprasidone in trichotillomania, so the model score should be treated as a research signal, not as evidence of benefit.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Australia Market Information
| ARTG Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| ARTG 9070J | ZIPROX | Capsule 20 mg (as hydrochloride), oral | Not recorded in the data compiled |
The drug is currently marketed in Australia as a single-ingredient oral product.
Safety Considerations
- Drug Interactions: The interaction data list 100 interacting drugs in total. The Major-level interactions among the entries reviewed include:
- hydrocortisone
- amphotericin B (including the lipid complex form)
- bupropion
- morphine
Moderate-level interactions include several glucose-lowering agents (metformin, pioglitazone, alogliptin, albiglutide, acarbose) and anticholinergic agents (atropine, hyoscyamine, glycopyrronium).
- Conditions flagged for caution: Disease-level contraindication records, which are not label text, flag several conditions:
- cardiac conditions: long QT syndrome, torsades de pointes, heart conduction disease, myocardial infarction and sudden cardiac arrest
- orthostatic hypotension
- epilepsy
- liver failure and kidney disease
- neutropenia and agranulocytosis
- diabetes and diabetic ketoacidosis
- hyperlipidaemia and obesity
Please refer to the TGA-approved Product Information (PI) for authoritative warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction is supported only by the model score (0.9983) and a hypothetical dopamine/serotonin link. No trial or publication in the compiled data directly studies ziprasidone in trichotillomania, so the evidence level is L5. The cardiac (QT) and metabolic safety profile also argues against moving forward without supporting data.
To proceed, the following is needed:
- A structured literature search for ziprasidone, or other D2/5-HT2A antagonists, in trichotillomania and related repetitive grooming behaviours
- Mechanism of action data to support the hypothesised link
- Review of the TGA Product Information for warnings and contraindications, with a cardiac (QTc) and metabolic risk assessment for the target population
- Confirmation of the approved indication text for ARTG 9070J
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.