Geodon for depression

Ziprasidone | Medications | Brightside

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Is ziprasidone (geodon) right for you?

There are many different types of antidepressant medications, and it’s important to find the one that’s right for you. At Brightside, we’re here to help. Our providers are knowledgeable about each type of medication for anxiety and depression and specialize in finding the best fit for your individual needs. As part of your treatment, your provider may recommend ziprasidone to help you feel better.

Ziprasidone is a commonly used antipsychotic medication that is often well tolerated. Below, we offer some helpful information about ziprasidone so you can work with your provider to determine if it’s right for you and make an informed decision about your care.

Mimi Winsberg, MD

Chief Medical Officer
Stanford-trained Psychiatrist with 25 years of practice

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Everything you need to know about ziprasidone

What is ziprasidone, and how does it work?

Ziprasidone, commonly sold under the brand name Geodon, is an antipsychotic medication first approved for usage in the United States in 2001. It is commonly prescribed to treat symptoms of schizophrenia, including delusions and hallucinations. It can also help treat manic or mixed-manic/depressive episodes in patients with bipolar disorder. Ziprasidone works by managing dopamine and serotonin levels in the brain to regulate thinking and behavior.

What conditions does ziprasidone treat?

At Brightside, our psychiatric providers specialize in personalizing treatment for each person. We give you personal attention and expert advice you can count. By using our expertise, we’ll help you find the medication that’s right for you. It’s important that you understand how medications work and what to expect so that your treatment is worry-free.

Our providers use ziprasidone primarily to treat symptoms of depression associated with bipolar disorder.

What symptoms can ziprasidone help treat?

Ziprasidone can target and treat several indicators of bipolar disorder. We use this medication to treat a number of symptoms, including:

Acute agitation
Delusions
Disorganized or nonsensical thinking
Episodes of mania mixed with episodes of depression
Feelings of frenzy or abnormal excitement (mania)
Hallucinations
Major depressive disorder with anxiety (also known as “anxious depression”)

Will ziprasidone work for me?

At Brightside, we can help you find the right medication and the right treatment specific to your needs. Your age, gender, genetic background, and other variables–including other medications you may be taking–can affect how well you respond to a certain medication.

To ensure that your medication is a fit for your personal health situation, our psychiatric providers will get to know your individual health history and talk with you about your symptoms and specific health needs.

You can expect to see an improvement in your depression or bipolar symptoms within 4-6 weeks after beginning ziprasidone. We understand that this can feel like a long time, but it’s important to continue taking your medication even if you don’t feel improvement right away. In some cases, your provider may need to adjust your dosage for you to get the maximum benefit from the medication. At Brightside, our board-certified providers will closely monitor your progress to make sure this medication and dosage is right for you.

We know that mental health concerns often can’t wait, so if you need to meet with a provider right away to discuss a new or existing medication, just let us know. We’re here for you.

How long do people generally take ziprasidone?

Once your provider prescribes ziprasidone for you, you may have questions – including how long you’ll need to take it. The length of time you’ll take this medication depends on your diagnosis and specific symptoms. You’ll likely continue taking this medication until your provider advises you to stop based on conversations with you and evaluations of your progress.

While there isn’t a specific amount of time ziprasidone is usually taken for, it’s essential to keep taking it even after you begin feeling better. Also, it’s a good idea to speak with your Brightside provider before you stop taking the medication, as they will work with you to adjust the dosage or treatment altogether.

How effective is ziprasidone?

Ziprasidone is approved by the US Food and Drug Administration for the acute treatment of psychosis in schizophrenia and mania in bipolar disorder. Data suggest that ziprasidone may be a first-line treatment for patients with bipolar mania.

Research has shown ziprasidone to be effective in the long-term treatment of schizophrenia and schizoaffective disorder.

Does ziprasidone change my personality?

Antipsychotic medications do not change your personality. Instead, they work to fight symptoms of bipolar disorder, including hallucinations, delusions, and manic episodes, so that you can get back to feeling more like yourself.

Are there side effects associated with ziprasidone?

Ziprasidone can cause minor side effects in some people. These include:

Agitation or restlessness
Constipation
Dizziness
Headache
Increased hunger
Nausea
Tiredness
Weight gain

Some patients using ziprasidone have developed tardive dyskinesia, a potentially permanent side effect that can cause involuntary muscle movement. More rarely, ziprasidone has been associated with a serious side effect called neuroleptic malignant syndrome, marked by an irregular heartbeat, high fever, and severe muscle stiffness.

Contact your Brightside provider right away if you experience any of the following symptoms:

Fainting
Fast or irregular heartbeat
High fever
Muscle spasms
Seizures
Severe muscle stiffness
Suicidal thoughts

At Brightside, your health and safety are our highest priorities. We make sure you get individual attention and guidance to make sure you feel your best.

Does ziprasidone have withdrawal symptoms?

You should not stop taking ziprasidone – or any antipsychotic medication – abruptly. Stopping ziprasidone suddenly can lead to a relapse of psychotic symptoms, including hallucinations, delusions, or manic episodes.

Quitting an antipsychotic medication abruptly can lead to an increased risk of suicide or self-harm. Sudden antipsychotic withdrawal has also been linked to the development of side effects, including muscle and motor control issues. If you wish to change your medication, you should plan to stop using ziprasidone slowly – gradually reducing your dosage under the close monitoring of one of our providers.

Can I take ziprasidone during pregnancy or while nursing?

Ziprasidone is categorized as a Pregnancy Category Class C drug by the FDA. This classification means that while extensive research on pregnant women has not been done, research using animals suggests that ziprasidone could potentially negatively impact a developing baby.

If you are pregnant or plan to become pregnant, you’ll want to talk with your provider to weigh the benefits and risks of beginning a ziprasidone prescription.

If you already use ziprasidone, discuss your case with your provider to see if the benefits of continuing with ziprasidone during pregnancy outweigh any potential risks to your baby. Because there has been little research on the safety of ziprasidone for nursing mothers, the National Center for Biotechnology Information suggests that other forms of antipsychotic medications may be preferred for lactating women.

Is ziprasidone addictive?

Ziprasidone is generally considered non-addictive and is not habit-forming.

What does the FDA say about ziprasidone?

You can view the FDA black box warning for ziprasidone here. If you have questions about whether the black box warning for ziprasidone applies to you, please talk to your provider.

Conditions we treat with ziprasidone

Brightside Psychiatric Providers prescribe ziprasidone alongside other medicines to treat conditions including:

Bipolar disorder
Major Depressive Disorder

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Ziprasidone (Geodon) | NAMI: National Alliance on Mental Illness

Brand name: Geodon®

Oral capsules: 20 mg, 40 mg, 60 mg, 80 mg
Intramuscular injection (short-acting): 20 mg/mL

Generic name: ziprasidone (zi PRAS i done)

Ziprasidone
- Oral capsule: 20 mg, 40 mg, 60 mg, 80 mg
- Intramuscular injection (short-acting): 20 mg/mL

All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.

What is Ziprasidone and what does it treat?

Ziprasidone is a medication that works in the brain to treat schizophrenia. It is also known as a second generation antipsychotic (SGA) or atypical antipsychotic. Ziprasidone rebalances dopamine and serotonin to improve thinking, mood, and behavior.

Symptoms of schizophrenia include:

Hallucinations – imagined voices or images that seem real
Delusions - beliefs that are not true (e.g., other people are reading your thoughts)
Disorganized thinking or trouble organizing your thoughts and making sense
Little desire to be around other people
Trouble speaking clearly
Lack of motivation

Ziprasidone may help some or all of these symptoms.

Ziprasidone is also FDA approved for the following indications:

Acute treatment of manic or mixed episodes of bipolar disorder
Maintenance (long-term) treatment of bipolar disorder (when used with lithium or valproate)
Acute treatment of agitation in schizophrenia

This medication sheet will focus primarily on schizophrenia. You can find more information about bipolar disorder here.

Ziprasidone may also be helpful when prescribed “off-label” for schizoaffective disorder. “Off-label” means that it hasn’t been approved by the Food and Drug Administration for this condition. Your mental health provider should justify his or her thinking in recommending an “off-label” treatment. They should be clear about the limits of the research around that medication and if there are any other options.

What is the most important information I should know about Ziprasidone?

Schizophrenia requires long-term treatment. Do not stop taking ziprasidone, even when you feel better.

With input from you, your health care provider will assess how long you will need to take the medication.

Missing doses of ziprasidone may increase your risk for a relapse in your symptoms.

Do not stop taking ziprasidone or change your dose without talking with your health care provider first.

For ziprasidone to work properly, it should be taken every day as ordered by your health care provider.

Are there specific concerns about Ziprasidone and pregnancy?

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with schizophrenia who wish to become pregnant face important decisions. This is a complex decision since untreated schizophrenia has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.

Antipsychotic use during the third trimester of pregnancy has a risk for abnormal muscle movements (extrapyramidal symptoms [EPS]) and/or withdrawal symptoms in newborns following delivery. Symptoms in the newborn may include agitation, feeding disorder, hypertonia, hypotonia, respiratory distress, somnolence, and tremor; these effects may be self-limiting or require hospitalization.

Caution is advised with breastfeeding since ziprasidone does pass into breast milk.

What should I discuss with my healthcare provider before taking Ziprasidone?

Symptoms of your condition that bother you the most
If you have thoughts of suicide or harming yourself
Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
If you ever had muscle stiffness, shaking, tardive dyskinesia, neuroleptic malignant syndrome, or weight gain caused by a medication
If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication.
Any psychiatric or medical problems you have, such as heart rhythm problems, long QT syndrome, heart attacks, diabetes, high cholesterol, or seizures
If you have a family history of diabetes or heart disease
All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
If you are pregnant, plan to become pregnant, or are breastfeeding
If you smoke, drink alcohol, or use illegal drugs

How should I take Ziprasidone?

Ziprasidone is usually taken 2 times per day with food (at least 500 calories).

Typically patients begin at a low dose of medication and the dose is increased slowly over several weeks.

The dose usually ranges from 40 to 80 mg twice daily. Only your health care provider can determine the correct dose for you.

Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member a friend to remind you or check in with you to be sure you are taking your medication.

What happens if I miss a dose of Ziprasidone?

If you miss a dose of ziprasidone, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.

What should I avoid while taking Ziprasidone?

Avoid drinking alcohol or using illegal drugs while you are taking ziprasidone. They may decrease the benefits (e.g., worsen your confusion) and increase adverse effects (e.g., sedation) of the medication.

What happens if I overdose with Ziprasidone?

If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

A specific treatment to reverse the effects of ziprasidone does not exist.

What are possible side effects of Ziprasidone?

Common side effects

Drowsiness, extrapyramidal symptoms, headache, dizziness, nausea, constipation, restlessness

Rare/serious side effects

Ziprasidone may increase the blood levels of a hormone called prolactin. Side effects of increased prolactin levels include females losing their period, production of breast milk and males losing their sex drive or possibly experiencing erectile problems. Long term (months or years) elevated prolactin levels can lead to osteoporosis, or increased risk of bone fractures.

Some people may develop muscle related side effects while taking ziprasidone. The technical terms for these are “extrapyramidal symptoms” (EPS) and “tardive dyskinesia” (TD). Symptoms of EPS include restlessness, tremor, and stiffness. TD symptoms include slow or jerky movements that one cannot control, often starting in the mouth with tongue rolling or chewing movements.

Temperature regulation: Impaired core body temperature regulation may occur; caution with strenuous exercise, heat exposure, and dehydration.

Second generation antipsychotics (SGAs) increase the risk of weight gain, high blood sugar, and high cholesterol. This is also known as metabolic syndrome. Your health care provider may ask you for a blood sample to check your cholesterol, blood sugar, and hemoglobin A1c (a measure of blood sugar over time) while you take this medication.

SGAs have been linked with higher risk of death, strokes, and transient ischemic attacks (TIAs) in elderly people with behavior problems due to dementia.

All antipsychotics have been associated with the risk of sudden cardiac death due to an arrhythmia (irregular heart beat). To minimize this risk, antipsychotic medications should be used in the smallest effective dose when the benefits outweigh the risks. Your doctor may order an EKG to monitor for irregular heartbeat.

Neuroleptic malignant syndrome is a rare, life threatening adverse effect of antipsychotics which occurs in <1% of patients. Symptoms include confusion, fever, extreme muscle stiffness, and sweating. If any of these symptoms occur, contact your health care provider immediately.

All antipsychotics can cause sedation, dizziness, or orthostatic hypotension (a drop in blood pressure when standing up from sitting or lying down). These side effects may lead to falls which could cause bone fractures or other injuries. This risk is higher for people with conditions or other medications that could worsen these effects. If falls or any of these symptoms occur, contact your health care provider.

Severe skin reactions have been reported with ziprasidone. These include Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and Stevens-Johnson Syndrome which can be fatal. Seek emergency treatment immediately if a severe skin reaction occurs.

Are there any risks For taking Ziprasidone for long periods of time?

Tardive dyskinesia (TD) is a side effect that develops with prolonged use of antipsychotics. Medications such as ziprasidone have been shown to have a lower risk of TD compared to older antipsychotics, such as Haldol® (haloperidol). If you develop symptoms of TD, such as grimacing, sucking, and smacking of lips, or other movements that you cannot control, contact your health care provider immediately. All patients taking either first or second generation antipsychotics should have an Abnormal Involuntary Movement Scale (AIMS) completed regularly by their health care provider to monitor for TD.

Second generation antipsychotics (SGAs) increase the risk of diabetes, weight gain, high cholesterol, and high triglycerides. (See “Serious Side Effects” section for monitoring recommendations).

What other medications may interact with Ziprasidone?

Ziprasidone may block the effects of agents used to treat Parkinson’s disease such as levodopa/carbidopa (Sinemet®), bromocriptine, pramipexole (Mirapex®), ropinirole (Requip®), and others.

The following medications may increase the risk of heart problems when used with ziprasidone:

Antipsychotics, including chlorpromazine (Thorazine®), thioridizine (Mellaril®), asenapine (Saphris®), iloperidone (Fanapt®), paliperidone (Invega®), and quetiapine (Seroquel®)
Antiarrhythmics (heart rhythm medications), including procainamide, quinidine, amiodarone (Cordarone®), dronedarone (Multaq®), and sotalol (Betapace®)

The following medications may increase the levels and effects of ziprasidone: fluoxetine (Prozac®), ketoconazole (Nizoral®), and paroxetine (Paxil®).

Carbamazepine (Tegretol®) may decrease the levels and effects of ziprasidone.

How long does it take for Ziprasidone to work?

It is very important to tell your doctor how you feel things are going during the first few weeks after you start taking ziprasidone. It will probably take several weeks to see big enough changes in your symptoms to decide if ziprasidone is the right medication for you.

Antipsychotic treatment is generally needed lifelong for persons with schizophrenia. Your doctor can best discuss the duration of treatment you need based on your symptoms and illness.

Hallucinations, disorganized thinking, and delusions may improve in the first 1-2 weeks
Sometimes these symptoms do not completely go away
Motivation and desire to be around other people can take at least 1-2 weeks to improve
Symptoms continue to get better the longer you take ziprasidone
It may take 2-3 months before you get the full benefit of ziprasidone

Summary of FDA Black Box Warnings

Increased mortality in elderly patients with dementia related psychosis

Both first generation (typical) and second generation (atypical) antipsychotics are associated with an increased risk of mortality in elderly patients when used for dementia related psychosis.
Although there were multiple causes of death in studies, most deaths appeared to be due to cardiovascular causes (e. g., sudden cardiac death) or infection (e.g., pneumonia).
Antipsychotics are not indicated for the treatment of dementia related psychosis.

Provided by

(November 2022)

©2022 The College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance on Mental Illness (NAMI). CPNP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.

This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

Geodon | Medicines in Israel

Geodon - Ziprasidone, 20/40/60 mg, 60/60/60 tab.

Geodon is an effective modern antipsychotic used to treat manic depression, schizophrenia and other mental disorders in adults and children from the age of ten.

Geodon is a safe atypical antipsychotic with a good tolerability profile containing the active ingredient ziprasidone. The drug has a special nature of interaction with neuroreceptors. Geodon most optimally correlates the blockade of serotonin and dopamine receptors, and also has a serious blocking effect on the receptors responsible for anxiety. Ziprasidone has similarities with neuronal serotonin transporters and other receptors that affect the appearance of feelings of drowsiness and orthostatic hypotension. The drug also has antidepressant activity. nine0005

The drug can be used to stop acute psychotic states, it significantly improves cognitive functions and reduces the manifestation of adverse symptoms with a noticeable improvement in the social activity of patients. Therapy with Geodon does not affect body weight and significantly reduces the chances of metabolic syndrome, and also lowers prolactin levels. The unsurpassed tolerability profile of Geodon makes it possible to treat individuals with resistance to other antipsychotics. nine0005

Dosage form:

Tablets

Dosage regimen

Treatment with the drug should be under the supervision of the attending physician.

Taken orally with food. The recommended starting dosage is 20 mg twice daily. Further, the dosage is adjusted individually, taking into account the clinical condition of the patient, increasing to a maximum daily dose of 100 mg 2 times a day (the maximum dose should not exceed three days).

Side effect

Use of Geodon may cause the following undesirable side effects:

Dizziness, drowsiness, extreme fatigue, nausea, stomach upset, defecation disorders, anxiety, tremors, skin rash, runny nose, new or worsening cough.

Before using the drug, you should consult your doctor.

Indications:

The drug is used for the prevention and treatment of schizophrenia, symptoms of bipolar disorder, mood disorders in schizophrenia, and other mental disorders. nine0005

Contraindications:

Cardiac arrhythmia;
History of QT prolongation;
Fresh or uncompensated heart failure myocardial infarction;
Psychotic conditions of patients associated with dementia, tk. this increases the likelihood of death in older people with dementia.
Use with a number of drugs, a list of which should be requested from your doctor, because. this can provoke a life-threatening tachycardia. nine0040

For which diseases it is used:

Schizophrenia, manic symptoms of bipolar disorder (manic depression).

Geodon | All medicines in Israel

Geodon - Ziprasidone, 20/40/60 mg, 60/60/60 tab.

Geodon is an effective modern antipsychotic used to treat manic depression, schizophrenia and other mental disorders in adults and children from the age of ten. nine0005

Dosage form:

Tablets

Dosage regimen

Treatment with the drug should be under the supervision of the attending physician.

Side effect

Use of Geodon may cause the following undesirable side effects:

Dizziness, drowsiness, extreme fatigue, nausea, stomach upset, defecation disorders, anxiety, tremors, skin rash, runny nose, new or worsening cough.

Before using the drug, you should consult your doctor.

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