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What is Ziprasidone?

By Michele Wyan
Updated May 17, 2024
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Ziprasidone is an antipsychotic drug.  It is used in the treatment of schizophrenia and the treatment of mania and mixed states in bipolar disorder.  When used in combination with lithium, the drug is also effective in the maintenance treatment of bipolar disorder.

The exact way that ziprasidone works is unknown.  Like other atypical antipsychotic drugs, though, ziprasidone is believed to inhibit the brain’s dopamine receptors.  It also is believed to inhibit the brain’s serotonin receptors.

This medicine comes in both capsules and an injectable form, which is used to treat acute agitation in schizophrenic patients. The capsules, the more common form taken, typically come in a dose of 20, 40, 60 or 80 milligrams.  They usually are taken twice a day.  Less of the drug gets absorbed if it’s taken on an empty stomach, so it should be taken with food.  A physician might start a patient on a minimal dose and increase the dosage as necessary to relieve the patient’s symptoms.  

Common side effects of ziprasidone include tiredness, nausea, constipation, diarrhea, rash, dizziness or muscle tremors.  It can also increase blood sugar.  Diabetic patients therefore need to closely monitor their blood sugar levels.  

In addition, ziprasidone is known to affect the rhythm of the heart.  Patients who have a history of heart problems should make sure their doctor is aware of their history, because the drug may be contraindicated for them.  Sometimes, patients on an antipsychotic drug such as ziprasidone can develop a condition known as tardive dyskinesia, which causes involuntary movements.  Stopping the drug might halt the condition, but the dyskinesia could be permanent.

One potentially fatal side effect that might arise with antipsychotic drugs such as ziprasidone is a complex called neuroleptic malignant syndrome (NMS).  Symptoms of NMS include fever, muscle rigidity, shaking, confusion, sweating or increased pulse and blood pressure.  Patients who are experiencing any of these symptoms after taking ziprasidone should contact their doctor immediately.

Another potentially fatal side effect of this medication sometimes occurs in elderly patients who have dementia.  These patients are at increased risk of stroke or death during treatment.  They should contact a physician immediately if they experience speech problems, dizziness, faintness or weakness or numbness in their arms or legs. 

Ziprasidone can have negative interactions with a number of other drugs.  Carbamazepine, for example, can make ziprasidone less effective.  Ketoconazole can increase the levels of the antipsychotic in the body and increase its side effects.  These possible adverse interactions are why it’s important for patients to communicate with their doctors and make sure that their doctors know every medication they’re taking.    

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