Pharm

Ziprasidone

search

Ziprasidone, Geodon

  • Indications
  1. Schizophrenia (including acute episodic Agitation)
  2. Mania
  3. Bipolar Disorder
  4. Tourette's Syndrome (not FDA approved)
  • Mechanism
  1. Primarily a Serotonin 2A antagonist (Dopamine antagonist activity is much less)
  • Class
  1. Atypical Antipsychotic (Second Generation agent)
  • Dosing
  1. Oral
    1. Ziprasidone 20 to 80 mg orally twice daily
  2. Parenteral
    1. Ziprasidone 10 to 20 mg IM
  • Advantages
  1. Minimal weight gain than with other Atypical Antipsychotics
  2. Lower risk of diabetes than with other Atypical Antipsychotics
  • Drug Interactions
  1. Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
    1. Clarithromycin
    2. Erythromycin
    3. Grapefruit juice
    4. Fluconazole
    5. Itraconazole
    6. Ketoconazole
  2. Decrease Antipsychotic levels (lower efficacy)
    1. Carbamazepine
    2. Phenytoin
  • Adverse Effects
  1. Lower Extrapyramidal Side Effects compared with other Antipsychotics
  2. Somnolence (esp. Overdose)
  3. Nausea
  4. Weakness
  5. QTc Prolongation (more than with other Atypical Antipsychotics)
  • Monitoring
  • References
  1. Glauser and Peters (2016) Crit Dec Emerg Med 30(4): 17-27