What Meds

Psychiatric Medications


Ziprasidone
Brand Name: Geodon

Overview
Geodon is the brand name for ziprasidone, an antipsychotic used to treat schizophrenia. It is an atypical (newer) antipsychotic whose structure is different than that of older antipsychotics. Geodon is somewhat similar to the antipsychotics Seroquel, Risperdal, Clozaril, and Zyprexa. This drug blocks both dopamine type 2 (D2) and serotonin type 2 (5HT2) receptors in neurons. It also blocks alpha(1)-adrenergic receptors and other dopamine and serotonin receptors, and has moderate affinity for histamine H(1) receptor.

Unlike most antipsychotics, Geodon is not associated with significant weight gain.

Why is this drug prescribed?
Geodon is FDA-approved for:

Geodon is used to treat both positive and negative symptoms of schizophrenia. Positive symptoms include hallucinations and delusions, while negative symptoms can include social withdrawal and apathy.

How much of this drug is typically used?
Capsule: 20, 40, 60, 80mg
Intramuscular powder for solution: 20mg

Warnings and Precautions
In the past, Geodon was associated with a risk of a heart rhythm irregularity by increasing the QTc interval (on an EKG). Several studies since then have shown that the risk of this is very slight and comparable to the risk from other antipsychotics, but it is a factor that must be considered by doctors and patients. Patients should have an EKG performed before starting Geodon to rule out underlying cardiac problems.

Geodon may impair the ability to drive or concentrate, especially at the beginning of therapy. Patients should not drive until Geodon’s effects are known.

Geodon slightly increases a patient’s risk of seizures, particularly in patients over 65.

For Pregnant or Nursing Mothers: Geodon causes fetal problems in animals, and is likely to do so in pregnant women. It is not known whether Geodon passes into breast milk, but breastfeeding while taking Geodon is not recommended.

Contraindications
Geodon should Not be used for people with the following medical conditions:

Precautions
Geodon may be used with caution in people with the following conditions:

Adverse Reactions
Geodon may cause the following reactions:

Rarely:

Geodon, along with other antipsychotics, is associated with a slight risk for Tardive Dyskinesia (TD). Geodon is believed to have a lower risk for TD than older antipsychotics. Symptoms of TD are grimacing, sucking and lip smacking, and other abnormal movements of the body or limbs, and should be reported to a doctor. Risk of TD is highest in older women.

Geodon is associated with a slight risk of heart rhythm problems. Symptoms of this include dizziness, fainting, and palpitations, and should be reported to a doctor.

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Geodon include:

Research Studies and Use in Child Psychiatry
Ziprasidone is used in a variety of conditions. It tends to cause less weight gain than other atypical antipsychotics such as olanzapine or risperidone, but still may cause some weight gain in children. It is recommended to obtain a baseline EKG in children taking ziprasidone, but the clinical effects on heart conduction are probably not as worrisome as was previously thought.

Bipolar disorder: One study of 46 children and adolescents with manic or mixed episodes of bipolar 1 disorder compared two doses of ziprasidone and found that both doses decreased scores on the Adolescent Structured Young Mania Rating Scale. A larger placebo-controlled study was just completed finding ziprasidone superior to placebo in treating children with mania and the results will soon be published.

Autism: One open-label study of 12 children with autism or PDD found that 6 of the 12 responded, with improvement in agitation, aggression, and irritability.

Early-onset schizophrenia: One open-label study of 40 children with schizophrenia found that ziprasidone was effective in slightly more than half of the patients treated.

Sources

Stanford Medicine Resources:

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