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What
is Geodon?
Geodon (ziprasidone) is an antipsychotic medication--one of
a group called "atypical" to distinguish these newer
drugs from older medications. The FDA approved Geodon as a
treatment for schizophrenia in 2001. It helps manage schizophrenia's
"positive symptoms," such as visual and auditory
hallucinations, delusions, and thought disturbances. Geodon
may also help in treating the "negative symptoms"
of schizophrenia, which include social withdrawal, apathy,
lack of motivation, and an inability to experience pleasure.
Geodon is associated with little or no weight gain, a characteristic
that distinguishes it from other antipsychotic drugs.
How
does Geodon work?
As with other atypical antipsychotic medications, Geodon may
reduce the positive symptoms of schizophrenia by blocking
the action of serotonin and dopamine, two neurotransmitter
chemicals, at specific chemical receptors in the brain. Geodon
also moderately inhibits the reuptake of serotonin and norepinephrine
into brain cells, which may improve both depressive and the
negative symptoms of schizophrenia.
Is
Geodon safe?
Several years ago, the FDA became concerned about the possibility
that ziprasidone and a number of other drugs might increase
the very small possibility of a specific, potentially fatal
heart-rhythm irregularity called torsade de pointes. The FDA
did not approve ziprasidone in 1998 because there was some
evidence that it could cause a lengthening of the so-called
QT interval of the heartbeat, a change associated with torsade.
The FDA asked for specific safety data, which were submitted
in 1999. Although "QT prolongation" is still a theoretical
concern, thousands of consumers have been treated in clinical
trials without evidence of the heart-rhythm irregularity.
And the overall mortality rate during the trials was similar
to that of placebo and with other antipsychotic drugs.
The FDA labeling
does not include a "black-box warning," usually
included when there is a significant risk that the doctor
must be aware of and take into account when prescribing, and
it does not recommend an EKG prior to or during treatment.
However, the labeling warns physicians and consumers about
QT prolongation and the possible risk of sudden death. The
FDA labeling suggests that doctors use their best judgment,
based on the health status of the individual, when considering
the use of ziprasidone as a first-line medication or only
after other medications have failed. There are no requirements
that consumers have regular heart check-ups while taking this
medication.
It is important
to note that your risk of dangerous heart-rhythm changes can
be increased by other medications you may be taking and other
heart conditions you may have. Therefore, you should tell
your doctor about all your other medications (including supplements
and non-prescription and herbal medicines) and any heart problems
you have now or have had. If you faint, lose consciousness,
or have heart palpitations while taking Geodon, contact your
doctor immediately.
What
are the common side effects caused by Geodon?
Some of the most common side effects associated with Geodon
are feeling unusually tired, nausea, constipation, dizziness,
restlessness, diarrhea, rash, cough and runny nose, and abnormal
muscle movements, including tremor, shuffling, and uncontrollable
movements.
Does
Geodon cause tardive dyskinesia?
Tardive dyskinesia (TD) is a disorder characterized by abnormal
movements of the mouth, limbs, or body that occur in some
people taking antipsychotic drugs. Researchers believe that
newer, atypical antipsychotics like Geodon are less likely
to cause TD than some older, conventional antipsychotics.
Because
it may take years until researchers can fully assess the risk
of TD when taking Geodon, this drug should be prescribed at
the lowest effective dose to minimize that risk. If you develop
symptoms of TD while taking Geodon--symptoms such as grimacing,
sucking and smacking of your lips, and other abnormal movements
of the body or limbs--you and your doctor should consider
switching medications. Keep in mind, though, that some people
may need to continue taking Geodon to most effectively control
their symptoms of schizophrenia despite developing TD.
What
should you tell your doctor if you are considering taking
Geodon?
Your physician should decide if Geodon is the best treatment
for you. If you are thinking about taking Geodon, be sure
to tell you doctor if you:
-
have had any problems with your heartbeat or heart disease
- have
a family history of heart disease
- have
had any problems with fainting or dizziness
- have
had any liver problems
- are
pregnant or plan to get pregnant
- are
breastfeeding
- are
taking any prescription or non-prescription medicines
- are
allergic to any medications
How
does Geodon interact with other medications?
There are some medications that may be unsafe to use when
taking Geodon, and there are some that can affect how well
Geodon works. Always tell your doctor about all drugs that
you are taking, including non-prescription drugs, supplements,
and herbal remedies.
-
Geodon should not be taken with any drug that affects the
QT interval of the heart rhythm, such as thioridazine (Mellaril),
quinidine (Quinidex), moxifloxacan (Avelox), pimozide (Orap),
and sparfloxacin (Zagam).
- Because
Geodon has a direct effect on the central nervous system,
people taking this drug should be cautious when taking other
drugs that affect the central nervous system.
- Studies
have shown that the anticonvulsant carbamazepine (Tegretol)
(commonly used as a mood stabilizer to treat bipolar disorder)
lessens the effects of Geodon.
What is the standard dose for Geodon?
The
lowest effective dose of any medication should always be used
to reduce the risk of troublesome and potentially harmful
side effects. The recommended initial dose of Geodon is 20
mg per day, but this dose may be increased to 80 mg twice
a day, depending on its effectiveness in each individual.
Increasing the dose beyond 80 mg twice a day is not recommended.
Your physician should watch for improvement of your symptoms
for several weeks before adjusting the dose because it may
take that long for the drug to produce its full effect.
What
else should I keep in mind when taking Geodon?
Geodon is available in capsules that should be swallowed whole
and taken with food. Women who are planning to become pregnant
or who are pregnant should discuss both the benefits and risks
with their doctor before taking Geodon. In addition, breast-feeding
is not recommended for women taking Geodon. Because dizziness
caused by a drop in blood pressure can occur while taking
Geodon, be careful when standing up and tell your doctor immediately
if you feel dizzy.
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