Ziprasidone (Geodon)


Clinical Information


HALF-LIFE: 6-7 hours


TARGET DOSING RANGE: 40mg-200mg daily (in divided doses)



Schizophrenia: Initial 20mg-60mg PO BID

Bipolar disorder: Initial 40mg PO BID for 2 days then increase to 60mg PO BID or 80mg PO BID

PREGNANCY: Minimal data on safety.

BREASTFEEDING: Minimal data on safety.

Side Effects

  • Sedation, dizziness, dry mouth, nausea, upset stomach, elevated prolactin levels (menstrual irregularities, sexual dysfunction, breast tenderness, headaches, galactorrhea), orthostatic hypotension, movement disorders, seizures (rare), Neuroleptic Malignant Syndrome (Rare), Arrhythmias (FDA issued a warning about QTc prolongation), extrapyramidal symptoms (parkinsonism, dystonia), akathisia/restlessness

FDA Indications

  1. Schizophrenia
  2. Acute agitation in schizophrenia
  3. Acute mania/mixed mania
  4. Bipolar maintenance

Off Label Uses: Bipolar Disorder, Acute agitation

Mechanism(s) of Action

  • Dopamine 2 (D2) Receptor Antagonist

Additional Information

  • Little to no propensity for weight gain, dyslipidemia, or insulin resistance
  • Must be taken with food (500 calorie meal) – Absorption is approximately doubled if taken with food
  • Intramuscular formulations (10mg-20mg) available


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