Ziprasidone is sold under the brand name "Geodon".
Ziprasidone is an atypical antipsychotic that is not related structurally to any of the other atypical antipsychotics. It is FDA approved for the acute and maintenance treatment of Schizophrenia and the acute treatment of Bipolar Disorder in adults over 18 years old.
Each of the atypical antipsychotics has its own profile or personality. Ziprasidone seems to have the least liability to weight gain of the atypical antipsychotics, but it can be sedating and/or agitating and finding a dose for a particular person to tolerate the ziprasidone can be quite challenging. The absorption of Geodon is facilitated by food and not taking it with food can significantly effect response.
Ziprasidone has complex mechanisms of action that include blockade of dopamine and serotonin receptors for its therapeutic benefits. It also releases serotonin and norepinephrine into the synapse, which is is unique to it. Ziprasidone in common with other atypical antipsychotics, blocks serotonin 2A receptors which confers relative protection against many of the serious adverse effects (e.g. tardive dyskinesia, akathisia and dystonic reactions) of the first generation, or typical, antipsychotics (e.g. haloperidal (Haldol), perphenizine (Trilafon), chlorpromazine (Thorazine), and others).
Ziprasidone is processed for elimination from the body (“metabolized”) in the liver to inactive compounds that are in turn eliminated by the kidneys. The half life of ziprasidone is relatively short so that it is generally dosed twice per day. It must also be taken with food for proper absorption through the gastrointestinal tract.
Possible adverse effects can include diabetes, weight gain, abnormal triglycerides and cholesterol, insulin resistance, increased Qtc interval, sedation, dizziness, dry mouth, constipation, and others. There is data that suggest this category of medication can rarely cause strokes in the elderly.
Ziprasidone, along with the other atypical antipsychotics, carries a warning from the FDA against the possibility of new onset diabetes mellitus. Guidelines for the appropriate medical monitoring of this category of medications for these possible medical adverse events were published in 2003. We follow these guidelines at Scott P. Hoopes, M.D., & Associates. It you are prescribed ziprasidone you will be referred to our Metabolic Clinic for medical monitoring. Following these guidelines is essential for the responsible use of all the atypical antipsychotics in patients of all ages.
Ziprasidone has no effects on liver enzyme systems and consequently does not significantly effect the elimination of other medications.
If you miss a dose of ziprasidone do not add the missed dose to the next dose. It is important to take ziprasidone regularly as prescribed and always with food.
