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Regarding the Use of Ziprasidone in Children and Adolescents

The Medicaid Drug Therapy Management Program for Behavioral Health (MDTMP) expert panel recommended doses for ziprasidone for children 6-11 and 12-17 because it determined that its use with children and adolescents would be appropriate for the following reasons

  1. Ziprasidone is occasionally used with children when other antipsychotic medications with FDA indications for pediatric populations have been tried and patient response was insufficient and/or side effects were particularly problematic. It would be inappropriate to prohibit a trial of ziprasidone under these circumstances
  2. Based on what we know from adult studies and from a small number of studies in pediatric populations, ziprasidone is less likely to cause weight gain and metabolic abnormalities than most of the other second generation antipsychotics that have FDA indications for children and/or adolescents. Therefore the risk associated with a trial of ziprasidone appears to be comparatively low.

Therefore, it is recommended that the Agency allow the reimbursement of ziprasidone among children 6-11 and 12-17 years old without prior authorization provided that the dosage used is within the parameters established by the MDTMP during its 2010 expert panel meeting to update the Medication Child/Adolescent Guidelines. Prior authorization should be required if the proposed dosage is above the maximum recommended by the panel and/or the child is under 6 years old.