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- What is ziprasidone, and how does it work (mechanism of action)?
- What are the side effects of ziprasidone?
- What is the dosage for ziprasidone?
- Which drugs or supplements interact with ziprasidone?
- Is ziprasidone safe to take if I'm pregnant or breastfeeding?
- What else should I know about ziprasidone?
What is ziprasidone, and how does it work (mechanism of action)?
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.
What brand names are available for ziprasidone?
Is ziprasidone available as a generic drug?
Do I need a prescription for ziprasidone?
What are the side effects of ziprasidone?
Some of the most common side effects associated with ziprasidone are:
- feeling unusually tired (1 in 7 patients),
- nausea (1 in 10),
- constipation (1 in 11),
- dizziness (1 in 12),
- restlessness (1 in 12), diarrhea (1 in 20), and
- rash (1 in 20).
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 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.
What is the dosage for ziprasidone?
Ziprasidone usually is taken twice a day. The usual starting dose is 20 mg twice daily. The dose may be increased over time to achieve the desired effect. Ziprasidone should be taken with food (for example, shortly after a meal) since when taken on an empty stomach, much less ziprasidone is absorbed.
Which drugs or supplements interact with ziprasidone?
Ziprasidone has a modest effect on the electrical activity of the heart which can be seen on the electrocardiogram (EKG) as a prolongation of the QT-interval. (See discussion below.) Other drugs which also affect the QT interval can add to the effects of ziprasidone and lead to serious disturbances in the rhythm of the heart. Due to the potential for such additive effects on the QT interval, ziprasidone should not be taken with thioridazine (Mellaril), quinidine (Quinidex), moxifloxacin (Avelox), pimozide (Orap), sotalol (Betapace), dofetilide (Tikosyn), and sparfloxacin (Zagam).
Carbamazepine (Tegretol) increases the body's ability to eliminate ziprasidone and, therefore, may reduce the levels and lessen the effectiveness of ziprasidone. Conversely, ketoconazole (Nizoral) reduces the body's ability to eliminate ziprasidone and may cause increases in levels of ziprasidone and more side effects. Ketoconazole does this by blocking the enzyme that eliminates ziprasidone, cytochrome P450 3A4. Other drugs that also block this enzyme and may increase the levels of ziprasidone include itraconazole (Sporanox), fluconazole (Diflucan), erythromycin, clarithromycin (Biaxin), nefazodone (Serzone), verapamil (Calan, Isoptin, Verelan), and diltiazem (Cardizem, Tiazac, Dilacor).
Is ziprasidone safe to take if I'm pregnant or breastfeeding?
Ziprasidone has not been studied in pregnant women, but studies in animals have shown that ziprasidone causes birth defects. Nevertheless, a physician may chose to use ziprasidone if he/she feels that its benefits outweigh this potential concern.
It is not known if ziprasidone is excreted in breast milk. Since most drugs are excreted in breast milk, it is recommended that women receiving ziprasidone should not breast feed their infants.
What else should I know about ziprasidone?
What preparations of ziprasidone are available?
Ziprasidone is available as capsules of 20 mg (blue/white), 40 mg (blue/blue), 60 mg (white/white) and 80 mg (blue/white). The injectable form is available in vials containing 20 mg of lyophilized ziprasidone that must be reconstituted with 1.2 ml of sterile water before injection.
How should I keep ziprasidone stored?
Capsules should be stored at room temperature, from 15 C to 30 C (59 F to 86 F).
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Ziprasidone (Geodon) is a medication (oral and injectable) used for treating psychoses such as schizophrenia and bipolar disorder. Side effects, drug interactions, warnings and precautions, and pregnancy information should be reviewed prior to taking any medication.
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Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood-stabilizer medications, antidepressants, and psychotherapy.
Brief Psychotic Disorder
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Bipolar Disorder vs. Schizophrenia
Bipolar disorder and schizophrenia are mental illnesses that share some risk factors and treatments. Symptoms of bipolar disorder include mood changes and manic and depressive episodes. Symptoms of schizophrenia include unusual behavior, delusions, and hallucinations.
Schizotypal Personality Disorder
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Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
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