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Geodon Side Effects: List of Common & Adverse Reactions

Geodon (Ziprasidone) is an atypical antipsychotic medication that has been approved by the FDA since 2001 to treat schizophrenia. It has also been found effective in addressing manic symptoms among individuals with bipolar disorder. In other cases, it is even used on an off-label basis as an antidepressant augmentation strategy and for various types of anxiety disorders; whether it should be used off-label for these conditions is highly debatable.

It works primarily as an antagonist of the D2 dopamine receptors. It also influences the H1 histamine receptors, Alpha-1 receptors, and affects the reuptake of serotonin. Although the drug may work well to help mitigate positive symptoms of schizophrenia such as hallucinations and delusions by having an antagonistic effect on dopamine receptors, this comes at a cost. Most people notice that Geodon carries significant side effects.

For many individuals it can be challenging to determine whether putting up with side effects from the medication are really worth any perceived benefit from the drug. Most people end up feeling heavily sedated and can become sluggish from the effects of this drug. If you are taking this medication and/or are considering it, below are some factors that influence its side effects.

Factors that influence Geodon side effects include:

As with any medication, there are factors that contribute to the drug’s side effects. The pharmacological properties of the medication are responsible for the bulk of the side effects, but other factors such as: the individual, dosage of the medication, duration over which a person took the drug, and whether they are also taking other drugs are all things that can influence side effects.

1. Individual Variation

Why does one psychiatric drug work well for someone, yet makes another person feel worse? Individual variation. Some people have positive reactions to certain drugs, yet for another, a drug may feel like hell on Earth. Some people will react to Geodon with intolerable side effects and feel as if the drug isn’t worth staying on.

Another individual may benefit from this medication, but may still have a tough time with the side effects. While a third person may take the drug and notice minimal side effects and really benefit from taking it. Realize that lifestyle factors, genetics, and stress can influence a person’s reaction to Geodon.

2. Dosage (20 mg to 80 mg)

Geodon is often taken within the range of 20 mg to 80 mg – twice daily with food. In general, the greater the dosage a person takes, the more influence the drug has over the body’s natural physiological functioning. Therefore it can be assumed that for most people, higher doses will result in more severe side effects. On the other hand, individuals who are taking a lower dose should theoretically have less overall side effects than if they were to take a greater dose.

At lower doses, the drug has less influence over your body and therefore will not stimulate certain receptors as much as at a higher dose. It should be noted that for this particular medication, it was found that there was no benefit to taking more than 20 mg twice daily – anything greater didn’t have a change in response. Doses near 80 mg or above 80 mg should be avoided for safety concerns as they are more likely to yield unwanted side effects.

Note: Geodon can also be administered via intramuscular injections – these are not recommended for more than a few consecutive days.

3. Time Span

When taking any drug, there are usually a couple types of side effects that develop – short-term and long-term. The ones that develop over the short-term tend to be a result of your body trying to adapt to the drug, while those that happen over the long-term are usually a result of the changes the drug has made to your physiology over time.

  • Short-term: Most people notice some short-term side effects because a new stimulus is being introduced to the nervous system. Since your brain and body have not accommodated for certain changes being made by the drug, side effects are common within the first few weeks. Many short-term side effects subside after a few weeks (once your body has gotten used to the drug).
  • Long-term: Some individuals may take the drug for an extended period of time and be tolerating it fine, and then notice side effects that become problematic after a year or two. Usually over the long term an individual has increased their dosage and the body has become more influenced by the drug – neurotransmitter adjustments, hormonal changes, etc. This can result in side effects that occur after a long duration of treatment.
  • Ongoing: Certain side effects will have occurred from the week that your started the medication, and continued throughout the duration for which you took the drug. These can be labeled as “ongoing” side effects and can often contribute to a patient justifying discontinuation. For example, someone may notice that their appetite increases after the first week of taking the drug, and it stays increased as long as the medication is continued.

4. Other Drugs

If you are taking any other medications with Geodon, it is important to consider that the side effects that you experience could be a result of those drugs. Additionally it is important to keep in mind that the side effects may also occur as the result of an interaction or contraindication. If you are concerned about any other drugs, supplements, or medications that you are using with Geodon, be sure to talk to your doctor. Those who suspect that this medication may be producing more side effects as a result of interaction with another substance may be correct.

Geodon Side Effects: List of Common Reactions

Below is an extensive list of common side effects for the medication Geodon. Keep in mind that what you experience may not involve every side effect listed below. Most people experience some side effects, but not everything on the list. This is a compilation of what research and users of the drug have reported as being accurate. The most commonly reported side effects of the entire list include headache and sleepiness.

  • Akathisia: This is an internal feeling of restlessness and the inability to sit still. A person experiencing this side effect may stay in constant motion and/or appear more fidgety than usual. If they sit in a chair, they may rock or sway back and forth. This is a common side effect with most antipsychotic drugs.
  • Anxiety: Although it is not as common to experience anxiety as some other side effects, Geodon can cause some individuals to feel anxious. If you notice that you feel increasingly anxious on this medication, chances are that it’s from the changes Geodon is making to your physiology. Fortunately this can usually be managed with some sort of an anti anxiety medication.
  • Appetite changes: Most antipsychotics cause people to become hungrier with increasingly large appetites. This is an unfortunate side effect from the medication that can contribute to weight gain. In less likely cases, people may lose their appetite as a result of feeling sick from other side effects.
  • Balance problems: Some people report that Geodon affects their ability to maintain balance and coordination. If you notice that your hand-eye coordination has worsened, the medication is a likely culprit. Generally the body will eventually adjust to initial balance difficulties as a result of dizziness.
  • Body aches: This drug can cause aches to occur throughout the body. The fact that it weakens the body’s muscles may also play a role in these aches. A loss of strength means that performing normal tasks may take a major toll on your muscular system; thus resulting in aches.
  • Chills: Certain individuals notice changes in body temperature and/or feel “chills” when they take Geodon. The chills can be caused by the body becoming sick as a result of this drug. Typically a person will eventually adapt to the drug and chills will subside, but if they continue, withdrawal may be necessary.
  • Confusion: Some people become increasingly confused when they take this drug. The confusion may interfere with their ability to understand their environment, complete work-related tasks, and hold conversations. A minor degree of confusion will occur in many individuals, but if the confusion is significant, you may want to talk to your doctor.
  • Concentration problems: The problem with most antipsychotics is that they interfere with focus. Although they help with various symptoms of schizophrenia, the fact that they act as a dopamine receptor antagonist is naturally going to affect cognition. This results in reduced ability to concentrate, learn new things, and complete mentally-demanding tasks.
  • Constipation: A relatively common side effect is that of constipation or inability to process bowel movements. While some people may experience the other end of the spectrum with diarrhea, constipation also occurs. In this event, you may want to make dietary tweaks that will help you cope.
  • Cough: Oddly enough, this medication can cause someone to develop a cough. The cough may be mistaken as a symptom of a “cold” or just general sickness, but it is important to realize that it can be an actual side effect. In the event that a person already has a cough, this drug may make it worse.
  • Depression: This drug is actually given to some patients with treatment-resistant depression as an adjunct. It is not approved for depression, and in many cases, it can result in worsening of depressive symptoms. If you become more depressed after taking Geodon, finding a different treatment option may be necessary.
  • Diarrhea: People who take this medication may notice loose stools or diarrhea. To counteract this side effect, it is often recommended to take some over-the-counter Imodium; this will help keep bowel movements under control. Unfortunately, this can be a longer lasting side effect that many people will not tolerate over the long-term.
  • Dizziness: Another common side effect that people experience is that of dizziness. If you feel more dizzy than usual and/or notice sensations of vertigo, chances are that it’s due to the drug. Feeling dizzy can be uncomfortable, but as your body adapts to the drug, it usually subsides.
  • Drowsiness: This is a drug that has moderate action on histamine receptors, meaning it can make people tired or drowsy. Therefore, it is recommended to avoid operating heavy machinery or motor vehicles while taking this medication. A psychiatrist may need to switch medications and/or figure out a way to offset this symptom if it becomes severe.
  • Dry mouth: You may notice that your entire mouth feels dry and is void of saliva. No matter how much water you drink, it doesn’t really help the dryness. Dry mouth is a side effect frequently reported by those who take psychotropic medications.
  • Extrapyramidal effects: These are symptoms such as tremors, dystonia, akathisia, and rigidity. In a comparison study of 15 antipsychotics, Geodon was ranked 8th for extrapyramidal effects – which is average. These tend to occur as a result of dopamine antagonism from continuous antipsychotic administration.
  • Fatigue: Many people become extremely fatigued on Geodon as a result of the dopamine receptor antagonism and the drug’s influence on histamine receptors. Some people report feeling low energy, drowsy, and sleepy while on this medication. If fatigue becomes unbearable, a medication change may be suggested.
  • Fever: Changes in bodily temperature may be experienced when a person first begins Geodon treatment. If a fever persists, be sure to talk to your doctor about discontinuation. Many people experience a fever as an initial side effect, but it eventually goes away once the individual adapts to the medication. It should also be noted that fever can be a sign of neurolpetic malignant syndrome in those who develop this condition.
  • Flu-like: A lot of people feel flu-like effects when they start taking Geodon. This may involve a fever, headache, dizziness, runny nose, and vomiting. You may feel as if you have some sort of viral infection or cold, when in reality it’s a reaction to the drug.
  • Headaches: This is among the most common side effect that a person will experience while taking Geodon. Estimates suggest that over 10% of individuals taking this medication will experience a headache. This may be an uncomfortable side effect, but usually the headaches aren’t severe enough to warrant discontinuation.
  • High blood pressure: Most psychiatrists will monitor your blood pressure with each visit. Should your blood pressure significantly increase, you may need to take antihypertensive medication such as Clonidine. This is an unfortunate side effect that many antipsychotics yield.
  • Insomnia: Despite common reports of sleepiness, some individuals may experience insomnia, or an inability to fall asleep at night. Others may be unable to stay asleep as a result of anxiety and/or internal restlessness. If you have insomnia, it may fade as you get more used to the drug.
  • Lightheadedness: You may notice that you feel lightheaded when taking this medication. The lightheadedness may occur when you sit up from a prone position. If it becomes severe enough, it may lead to fainting. Be sure to monitor this side effect if you suspect that it may become problematic.
  • Memory loss: The potency of antipsychotic medications can have a detrimental impact on cognition and memory functioning. Over time, you may notice that your memory has gotten worse, you become more confused, and can’t remember as much information. This is because your neurotransmitters, particularly dopamine have been largely influenced by the drug.
  • Muscle stiffness: A side effect that some people notice is muscular stiffness. You may feel as if all of your muscles and joints have become increasingly rigid and/or stiff. Should you notice increased stiffness, be sure to be aware that it may also be a sign of “neuroleptic malignant syndrome.”
  • Nausea: People may become nauseous within the first couple weeks of using Geodon. If you continue to use this drug and the nausea doesn’t diminish, you may want to consider something else. In some cases, the nausea can become so extreme that it leads a person to vomit.
  • Palpitations: You may feel sensations as if your heart is pounding more substantially than usual or as if it is racing – these are known as palpitations. These palpitations can be worsened if you are also experiencing anxiety.
  • Rash / Itching: In some unfortunate cases, people can develop a body rash. This can signify an allergic reaction to the medication, but may just be a side effect. For some people the rash goes away or subsides in intensity. This rash may also be itchy and difficult to cope with.
  • Restlessness: Akathisia and restlessness go hand-in-hand. Someone who feels inner sensations to move around as a result of the drug is likely going to engage in restless behavior. If you experience this side effect, you could go on a walk or get a workout to help curb some of this extra energy.
  • Runny nose: This may be accompanied by a cough and is another odd “cold-like” symptom that can occur while on this medication. Some may initially believe that they are getting sick from a virus or external source, when in reality the runny nose was caused by the medication.
  • Sexual dysfunction: The increase in prolactin levels can contribute to major sexual dysfunction. In addition to the prolactin as a contributor, dopaminergic alterations and stimulation of histamine receptors can make some individuals completely uninterested. Libido may significantly drop as well as the ability to orgasm.
  • Sleepiness: Even though Geodon may be working to manage symptoms of schizophrenia, the management comes at a cost. Many people who take this drug feel extremely tired, almost to the point that they cannot function. This drug reduces the amount of dopamine activity in the brain, and zaps a person of their energy – often leading to excessive sleep.
  • Sweating: Many people notice an increase in sweating as a side effect. Some people may sweat profusely, while others may just notice a little bit of an increase in body sweat. The sweating may occur throughout the day and/or at night.
  • Suicidal thoughts: The alterations made by this drug to various neurotransmitters doesn’t always result in an improved mood. In some cases, people actually end up feeling significantly worse than they did prior to taking Geodon, which can lead to suicidal thoughts. If you feel suicidal or notice an increase in suicidal thinking, be sure to seek immediate medical attention.
  • Tremors: It is common to notice tremors or minor shakes throughout your body while adjusting to this drug. The tremors may not be severe, but should be closely monitored as they may lead to other, more severe conditions like tardive dyskinesia.
  • Vomiting: Some people may become sick as a result of using this drug. If you notice that you feel nauseous, you may end up vomiting. The vomiting can be normal during the initial couple weeks that you take the drug, but if it persists, you may need to pursue other treatment options.
  • Vision changes: Many people note changes in their field of vision while taking this drug. Vision changes can be the result of neurotransmitter changes and alterations to brain activity. In many cases people may note that their vision is blurry. If you notice any changes in your vision, be sure to monitor it closely as some believe antipsychotics can damage the eye.
  • Weight gain: All antipsychotics are associated with weight gain due to the fact that they slow metabolism, increase appetite, and cause drowsiness. The combination of these three factors makes it very difficult to not pack on serious weight throughout treatment.

Geodon Severe Side Effects / Adverse Reactions

The unfortunate aspect of taking an antipsychotic medication is that you may experience a severe side effect or adverse reaction. These medications are highly potent, and Geodon is no exception. If you notice any of the following symptoms, be sure to talk to your doctor immediately as you may need to discontinue this medication.

  • Breast enlargement: Both men and women are capable of experiencing breast enlargement as a result of this medication. It increases the hormone prolactin to a significant extent, and when this hormone builds up, men can develop breasts – this condition is known as gynecomastia.
  • Death risk: This drug is associated with an increased risk of death among those with dementia-related psychosis. Therefore, it is recommended to avoid this particular drug if you want to live as long as possible. Some suggest that this is a poor choice of drug to use for this condition specifically because it carries extra risk of death for individuals with dementia.
  • Diabetes: Atypical antipsychotic medications can change blood sugar levels, and many have been associated with the development of Type 2 diabetes. Although this is a relatively rare symptom, many people have developed diabetes permanently as a result of using antipsychotics.
  • Fainting: If this medication has made you faint, seek immediate medical attention. If you faint, you may need to reduce the dose and/or withdraw from this particular medication. Fainting is a sign that you may not be able to tolerate the drug.
  • High cholesterol: Unfortunately many antipsychotics can affect cholesterol levels. You may be doing everything you can to keep your cholesterol in check, but no matter what, it seems to stay high. The high cholesterol is often a result of your body operating under the influence of Geodon.
  • Neuroleptic Malignant Syndrome: This is an adverse reaction to antipsychotic medications that sometimes occurs. It is characterized by rigid muscles, fever, and a state of delirium. It can be a life threatening condition and lead to coma if not treated. This is a result of D2 dopamine receptor antagonism from the Geodon.
  • QT Prolongation: For some individuals, Geodon can cause QT prolongation, which essentially means that it negatively affects your heart rhythms. This condition can be deadly and in some cases, can result in permanent development of various tachycardias. If this occurs, you will likely be advised to discontinue this medication.
  • Seizures: Some people may experience seizures as an adverse reaction to this particular drug. Most people will not experience seizures as this is an extremely rare reaction to Geodon.
  • Slurred speech: If you notice that your speech slurs and you are unable to speak clearly, this may become an ongoing problem. Those who are unable to speak properly following the use of this medication will likely be advised to discontinue.
  • Tardive Dyskinesia: With Geodon, the occurrence rate of this side effect is relatively low. The properties of the drug make it less likely to result in extrapyramidal effects. If you notice involuntary movements in your facial area (especially lower face), you may be developing this condition. This is extremely rare though and only occurs over the course of long-term treatment.

Geodon: Weighing the Side Effects (Cons) vs. Benefits (Pros)

When taking Geodon, it is important to conduct a little cost-benefit analysis, weighing the pros and cons of the medication. Take the time to do some self-reflection throughout your treatment and ask yourself whether the side effects are worth the benefits you are getting from the drug. If Geodon is helping to manage your schizophrenia, but the side effects are so debilitating that all you end up doing is sleeping all day – that’s a problem.

If Geodon is working well, but you have a few mild side effects, chances are you’ve found a good treatment option. If the medication isn’t even helping treat your particular mental illness and you are experiencing side effects, it’s obvious that you’ll need to explore other options. Those who have already explored other antipsychotics and have only gotten relief from Geodon may be willing to put up with a few more side effects than others.

Realize that nearly every antipsychotic is going to have side effects and that you should only take this class of medication for conditions that warrant its usage (e.g. schizophrenia). If you have taken Geodon, feel free to share any side effects that you experienced in the comments section below.

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{ 5 comments… add one }
  • bonnie March 13, 2015, 12:56 am

    After being off geodon for one year my doctor started me back on at 80 mg once a day. After the first day I started being anxious and restless. The next night I started having paralyzing nightmares and would wake up in a total panic attack. I called her and told her my symptoms, and she had me increase my next dose 160 mg. The symptoms got so severe I got up pacing the floor unable to control my fear. I went to the ER and received no treatment.

    Same scenario the next night without taking anymore medication back to the ER, given a shot of ativan. Next day I called my doctor, and she called in ativan, 1 mg 3 times a day. I could not tolerate how it made me feel. I have not felt right ever since. I’m seeing black tracers, and feel like I’m in a fog and dizzy. I have an appointment with a new psychiatrist. I just wonder what happened to me? Have other people had this reaction?

    • Jeff March 11, 2016, 2:01 am

      Hello Bonnie, I’ve heard of this happening to people. It works ok for me with the exception of concentration issues.

  • Kathy April 3, 2016, 2:58 pm

    Hello my daughter has been on this 5 days and is restless and having horrible nightmares to actually wetting the bed because it scares her so. She also saying she sees dead people. Will this go away?

  • Gary T May 30, 2016, 9:16 pm

    My daughter has been forced to take this medication by her mother, who has sole custody. She experienced all those side effects and worse her IQ has been lowered, and she is experience akathisia, I only hope that permanent tardive dyskinesia is not next in line. The horrible thing is, she did not need it, and it was given to her to quell her angst and sadness from losing me her father. A horrible tragedy to an innocent little girl. Here is the psychiatrist that gave it to her without my knowledge or permission: https://www.youtube.com/watch?v=8Tpl-1AoDOw

  • Sabrina August 27, 2016, 7:02 pm

    I have been taking 80 mg at night for over 6 months. And I have been fine. Well my doctor up mine to 160 mg at night because I admitted not eating a good meal before I take the medicine and I have had some manic outbursts. Well I woke up today cold chills and severe body aches. I cant take that much ever again.

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