ziprasidone (Geodon)

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GENERIC NAME: ziprasidone


DRUG CLASS AND MECHANISM: Ziprasidone is an oral and injectable drug that is used for treating psychoses, for example, schizophrenia. Although the mechanism of action of ziprasidone is not known, like other anti-psychotics, it inhibits communication between nerves of the brain. It does this by blocking receptors on the nerves for several neurotransmitters, the chemicals that nerves use to communicate with each other. It is thought that the beneficial effect of ziprasidone is due to its blocking of dopamine and serotonin receptors. It also inhibits the re-uptake of serotonin and norepinephrine by nerves in the brain like some anti-depressant drugs. Ziprasidone is associated with little or no weight gain, a feature that distinguishes it from other anti-psychotic drugs. Similarly, ziprasidone is unique among anti-psychotic drugs in that it does not increase cholesterol levels. The FDA approved ziprasidone as a treatment for schizophrenia in February 2001.

PRESCRIBED FOR: Ziprasidone is used to treat severe mental disorders like schizophrenia, which are characterized by distorted thoughts, perceptions, and emotions. Ziprasidone helps manage schizophrenia's "positive symptoms," (visual and auditory hallucinations, and delusions) and may also help in treating the "negative symptoms" of schizophrenia (social withdrawal, apathy, lack of motivation, and an inability to experience pleasure). Ziprasidone also is used to treat acute bipolar mania (manic and mixed episodes) and, in combination with lithium (Lithobid) or valproate (Depakote, Depakote ER, Depakene, Depacon, Stavzor), for maintenance treatment of bipolar disorder.

SIDE EFFECTS: Some of the most common side effects associated with ziprasidone are:

Ziprasidone may cause a a condition consisting of abnormal muscle movements, including tremor, shuffling, and uncontrollable movements (1 in 20 patients).

There is a slight risk (1 in 1500 patients) that ziprasidone by itself could significantly increase the QT interval. There is an even smaller risk (1 in 4000 patients) that it could cause a potentially serious change in the rhythm of the heart.

Ziprasidone causes orthostatic hypotension, a drop in blood pressure upon rising that can cause dizziness or lightheadedness. The risk is about 1 in 200 patients.

Ziprasidone frequently causes tiredness (1 in 7 patients). Therefore, care should be exercised in any activity requiring mental alertness, such as operating a motor vehicle (including automobiles) or operating hazardous machinery. Less common side effects include seizures (1 in 250 patients).

As with other antipsychotics, long-term use of ziprasidone may lead to a potentially irreversible condition called tardive dyskinesia (involuntary movements of the jaw, lips, and tongue).

A potentially fatal complex referred to as neuroleptic malignant syndrome (NMS) has been reported with other anti-psychotic drugs. Patients who develop NMS may have high fevers, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid heart rate, excessive sweating, and heart arrhythmias.

Although there is no clear link between ziprasidone and diabetes, patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.

Medically Reviewed by a Doctor on 10/16/2015

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