Sertindole: pharmacological and clinical profile and role in the treatment of schizophrenia

BACKGROUND: Sertindole is a second-generation antipsychotic recently reintroduced in the market for the treatment of schizophrenia after a reevaluation of its risks and benefits. OBJECTIVE: This article provides an overview of the pharmacological properties of sertindole as well as of its efficacy, tolerability and safety profile. METHODS: Several clinical trials and large-scale epidemiological studies have evaluated the efficacy and tolerability of sertindole in patients with schizophrenia. RESULTS/CONCLUSIONS: Findings from controlled clinical trials have demonstrated that sertindole is at least as effective as haloperidol and risperidone against the positive symptoms of schizophrenia, while it appears superior against negative symptoms. Preliminary evidence suggests that sertindole has beneficial effects on cognitive function. Sertindole is associated with a low rate of extrapyramidal side effects, lacks sedative properties, and may induce a moderate weight gain. No clinically relevant elevations in serum prolactin, glucose or lipid levels have been so far documented in sertindole-treated patients. On the other hand, administration of sertindole may result in a prolongation of the QTc interval, with subsequent risk of serious arrhythmias. However, postmarketing surveillance studies have recently indicated that sertindole is not associated with a higher rate of cardiovascular mortality than other antipsychotic agents.