Generic name: Ziprasidone hydrochlorideBrand names: Geodon
Geodon is used to treat schizophrenia and the manic episodes of bipolar disorder. Researchers believe it works by opposing the action of serotonin and dopamine, two of the brain's major chemical messengers. Because of its potentially serious side effects, Geodon is typically prescribed only after other medications have proved inadequate.
Geodon is usually taken in capsule form. An injectable version is available for quick relief of agitated patients. Injectable Geodon is generally used for no more than a few days.
In some people with heart problems or a slow heartbeat, Geodon can cause serious and potentially fatal heartbeat irregularities. The chance of a problem is greater if you are taking a water pill (diuretic) or a medication that prolongs a part of the heartbeat known as the QT interval. Many of the drugs prescribed for heartbeat irregularities prolong the QT interval and should never be combined with Geodon. Other drugs to avoid when taking Geodon include chlorpromazine, gatifloxacin, mefloquine, mesoridazine, moxifloxacin, pentamidine, pimozide, soarfloxacin, tacrolimus, and thioridazine. If you're uncertain about the risks of any drug you're taking, be sure to check with your doctor before combining it with Geodon.
Geodon is not approved for elderly patients with dementia-related psychosis (such as the type that may occur with Alzheimer's disease) due to the risk of sudden death, heart failure, pneumonia, and stroke.
Geodon capsules should be taken twice a day with food.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Geodon.
Do not take Geodon if you have the heartbeat irregularity known as QT prolongation, have had a recent heart attack, or suffer from heart failure. You'll also need to avoid Geodon if it gives you an allergic reaction.
Remember that Geodon can cause dangerous—even fatal—heartbeat irregularities. Warning signs include dizziness, palpitations, and fainting. Tell your doctor immediately if you experience any of these symptoms. Be careful to avoid drugs that prolong the QT interval of the heartbeat. Check with your doctor before combining any other medication with Geodon.
Particularly during the first few days of therapy, Geodon can cause low blood pressure, with accompanying dizziness, fainting, and rapid heartbeat. Tell your doctor if you experience any of these side effects. To minimize such problems, your doctor will increase your dose gradually. If you are prone to low blood pressure, take blood pressure medicine, become dehydrated, or have heart disease or poor circulation in the brain, use Geodon with caution.
Geodon may cause drowsiness and can impair your judgment, thinking, and motor skills. Use caution while driving and don't operate potentially dangerous machinery until you know how Geodon affects you.
Geodon poses a very slight risk of seizures, especially if you are over age 65, have a history of seizures, or have Alzheimer's disease.
Drugs such as Geodon sometimes cause a condition called Neuroleptic Malignant Syndrome (NMS). Symptoms include high fever, muscle rigidity, irregular pulse or blood pressure, rapid heartbeat, excessive perspiration, and changes in heart rhythm. If these symptoms appear, tell your doctor immediately. You'll need to stop taking Geodon while the condition is under treatment.
There also is the risk of developing tardive dyskinesia, a condition marked by slow, rhythmical, involuntary movements. This problem is more likely to occur in mature adults, especially older women. When it does, use of Geodon is usually stopped.
While taking Geodon, some patients with bipolar disorder reported having anxiety, restlessness, depression, dizziness, muscle twitching, rashes, and vomiting. Contact your doctor immediately if you develop these symptoms.
Geodon can suppress the cough reflex; you may have trouble clearing your airway. Some people taking Geodon also develop a rash. Tell your doctor when this happens. If the rash doesn't clear up with treatment, you may have to discontinue the drug.
Other antipsychotic medications have been known to interfere with the body's temperature-regulating mechanism, causing the body to overheat. Although this problem has not occurred with Geodon, caution is still advisable. Avoid exposure to extreme heat, strenuous exercise, and dehydration. There also is a remote chance that Geodon may cause abnormal, prolonged and painful erections.
Animal studies suggest that Geodon may increase the risk of breast cancer, although human studies have not confirmed such a risk. If you have a history of breast cancer, see your doctor regularly for checkups.
Remember that you must never combine Geodon with any drug that prolongs the part of the heartbeat known as the QT interval (see "Most important fact about Geodon"). Check with your doctor or pharmacist if you have any doubts about a drug you're taking.
If Geodon is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Geodon with the following:CarbamazepineCertain blood pressure medicationsDrugs that boost the effects of dopamine such as bromocriptine, pramipexole, and ropiniroleDrugs that affect the brain and nervous system, such as sedatives, tranquilizers, and antidepressantsKetoconazoleLevodopa
Geodon has caused fetal harm when tested in animals. It should be taken during pregnancy only if the benefits outweigh the potential risk. Notify your doctor as soon as you become pregnant or plan to become pregnant.
It is not known whether Geodon appears in breast milk, and breastfeeding is not recommended.
The usual starting dose is 20 milligrams twice a day. If needed, the dosage may be increased at several-week intervals up to a maximum of 80 milligrams twice a day.
Acute Manic Episodes Associated with Bipolar Disorder
The usual starting dose is 40 milligrams twice a day with food. On the second day of treatment, the doctor will increase the dose to 60 or 80 milligrams twice a day. For maintenance treatment, the dosage range is usually 40 to 80 milligrams twice a day.
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical help immediately.