What is already known on this topic?

Anxiety disorders are common among patients with bipolar disorder. Bipolar patients with anxiety disorders have poorer treatment outcomes, greater numbers of suicide attempts, higher rates of substance abuse and lower quality of life.1 Complicating treatment, standard antianxiety agents, such as antidepressants, may worsen the course of bipolar disorder, and there is conflicting evidence about antipsychotics. Some data support the use of quetiapine2 or olanzapine for the treatment of bipolar anxiety, while one trial found risperidone to be ineffective.3

What does this paper add?

• Ziprasidone treatment was ineffective compared with placebo in reducing anxiety symptoms.

• Ziprasidone was more poorly tolerated and led to significantly higher rates of early termination than placebo.

Limitations

• Generalisability of this study's results is limited because patients were not on any mood stabiliser at the time of enrolment. Thus, whether ziprasidone added to …