Severe psychiatric symptoms and neurological impairment may occur during treatment with ziconotide. Patients with a pre-existing history of psychosis should not be treated with ziconotide.
All patients should be monitored frequently for evidence of cognitive impairment, hallucinations, or changes in mood or consciousness.
Ziconotide therapy can be interrupted or discontinued abruptly without evidence of withdrawal effects in the event of serious neurological or psychiatric signs or symptoms.