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Geodon (Ziprasidone) Drug Profile

Bipolar Medications Library

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Updated July 28, 2012

The United States Food and Drug Administration (FDA) approved the antipsychotic medication Geodon (ziprasidone) in early 2001 for the treatment of schizophrenia and schizoaffective disorder. In 2004, the FDA extended its approval to include Geodon as a monotherapy in the treatment of acute manic or mixed episodes in bipolar I disorder, with or without psychotic features. In November 2009, Geodon received FDA approval for a new use - as maintenance treatment for bipolar disorder when used with lithium or valproate (Depakote, etc.). The most exciting aspect of adding this medication to the schizophrenia / bipolar arsenal is that, unlike earlier antipsychotics, Geodon is not associated with weight gain.

In a six-week, head-to-head study between Zyprexa (olanzapine) and Geodon, it was found that the two medications performed equally as well in alleviating psychotic symptoms such as hallucinations, delusions, paranoia and withdrawal. However, the Zyprexa patients' median weight gain over the six weeks was ten pounds, while Geodon patients gained less than one pound. In line with this finding, Zyprexa patients saw significant increases in cholesterol and other blood fats, while Geodon patients lipid profiles remained stable.

These results suggest that not only is Geodon a healthier alternative, but patients may also be less inclined to stop taking it on their own due to weight gain.

Important Caution About Geodon

There is a slight risk (less than one in 4,000, as far as can be determined so far) that Geodon could cause a potentially dangerous change in heart rhythm. According to the drug's patient insert, you should not take this medication if you have heart diseases such as long QT syndrome, a recent heart attack, severe heart failure, or some heart rhythm irregularities. You should tell your doctor if you've noticed anything out of the ordinary in terms of the way your heart beats and whether or not you have had heart problems in the past. Also share information on other medications (prescription and over-the-counter) and supplements (including herbal teas) you are taking.

Geodon Dosage Information

According to Pfizer, the recommended initial dose of Geodon is 20 mg twice a day. They add, "In some patients, daily dosage may subsequently be adjusted on the basis of individual clinical status up to 80 mg [twice a day]. Dosage adjustments, if indicated, should generally occur at intervals of not less than 2 days, as steady-state is achieved within 1 to 3 days. In order to ensure use of the lowest effective dose, ordinarily patients should be observed for improvement for several weeks before upward dosage adjustment."

Drug Interactions With Geodon

The patient information says that you should not take Geodon in combination with Quinidex (quinidine), Orap (pimozide), Betapace (sotalol), Mellaril (thioridazine), Avelox (moxifloxacin) or Zagam (sparfloxacin), all of which can also affect the QT interval of the heartbeat. Other Class Ia and III anti-arrhythmics (drugs taken for irregular heartbeat) are also on the list of drugs that should not be taken along with Geodon. Again, be sure your doctor is aware of any heart medications you are taking.

Carbamazepine, sold under the brand names Tegretol and others, can reduce the effectiveness of Geodon. There were no reported interaction problems between Geodon and Lithium or oral contraceptives.

Other Geodon Warnings

In addition to the above concerns about heart disease and current medications, before you start taking Geodon, tell your doctor if you:
  • Have a family history of heart disease
  • Have ever had problems with dizziness/fainting
  • Have ever had liver problems
  • Are pregnant or breast feeding, might be pregnant, or are planning a pregnancy
  • Have allergies to any medications
Do not drink alcoholic beverages if you are taking Geodon.

Be careful not to stand up suddenly when taking Geodon, as one side effect can be dizziness caused by a drop in blood pressure. If you accidentally take too much, call your doctor or poison control center immediately, or go to the nearest emergency room.

Geodon Side Effects

You should contact your doctor immediately if you faint or pass out, or if you feel any change in the way your heart is beating while taking Geodon. This is extremely important.

Common Geodon side effects include:

  • Tiredness or sleepiness
  • Nausea
  • Constipation
  • Dizziness
  • Restlessness
  • Diarrhea
  • Rash
  • Cough/runny nose
  • Abnormal muscle movements, such as tremor, shuffling, uncontrolled involuntary movements
Disclaimer: This profile is not intended to be all-inclusive or to replace information provided by your doctor or with the prescription from the manufacturer.

Source:

Pfizer, Inc. "Geodon Full Prescribing Information."

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