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Does Geodon (Ziprasidone) Cause Weight Gain, Loss, or Remain Neutral?

Geodon (Ziprasidone) is an atypical antipsychotic that was approved by the FDA in 2001 for the treatment of schizophrenia. It has since been approved to manage both manic and mixed states of bipolar disorder. In some cases, the drug is used as an antidepressant augmentation strategy for the treatment of refractory depression, as well as for various types of anxiety disorders.

In comparison to other antipsychotics, studies demonstrate that it is less effective than Zyprexa, but roughly the same efficacy as Seroquel. The drug functions primarily as an antagonist of the D2 dopamine receptor, but also tends to inhibit the 5-HT2A receptor. Its effects on the D2 receptors result in reduced positive symptoms of schizophrenia. It also inhibits the reuptake of the neurotransmitters norepinephrine and serotonin, which may help with negative symptoms.

Geodon and Weight Changes

Geodon differs from other antipsychotics in that it is very unlikely to cause weight gain. This is likely due to the fact that the drug doesn’t affect the muscarinic acetylcholine receptors (mACh), resulting in no anticholinergic side effects. The most likely side effects that you’ll experience while taking this medication include: sedation and orthostatic hypotension. A majority of medical professionals regard this drug as being “weight neutral” in that no studies link this drug to significant weight gain.

Geodon is a “weight neutral” antipsychotic

Many people that are concerned about gaining weight on an antipsychotic end up trying Geodon. Although a small percentage of individuals may still end up gaining weight, another small percentage of individuals actually end up losing weight. The majority of people do not report any significant weight change throughout treatment with the drug, therefore it should be considered “weight neutral.”

The hormone “leptin” has been found to not increase after 4-week trials of Geodon. The hormone leptin is responsible for appetite stimulation and regulation. When taking other atypical antipsychotics, it tends to increase, resulting in significant appetite increase as well as weight gain. Since Geodon doesn’t tend to increase leptin levels, this is likely reason (in part) as to why weight gain is uncommon.

Could Geodon Cause Weight Gain?

Despite the fact that research suggests Geodon is unlikely to cause weight gain, some people still end up gaining weight throughout their treatment. Even though the medication isn’t likely to cause a weight increase, some people still end up gaining weight… Below is a list of reasons as to why you may still gain weight.

  • Appetite increase: If the drug increases your appetite, you may end up eating more overall food than you did before. It can be difficult to control yourself when a drug significantly increases your appetite. This tends to be more of a problem with other antipsychotics, but could still happen while on Geodon.
  • Cravings: The drug-induced changes to neurochemical processes in the brain can lead some people to crave food. If you start craving foods while on Geodon, it’s probably an individualized reaction (and may be temporary). These cravings make it difficult to resist unhealthy foods and often lead to overeating.
  • Eating out: If the medication is working well to control your symptoms, you may end up feeling more comfortable in public and may be more likely to dine out with friends or family. Feeling more comfortable in social situations could lead to more frequent meals with friends. Eating out is typically a cause of weight gain due to the fact that portions tend to be larger and foods are usually unhealthier.
  • Hormones: This drug may affect various levels of hormones throughout the body, which could cause weight gain. It may increase the hormone prolactin, while decreasing testosterone levels in men, leading to muscle loss and an increase in body-fat. If you start gaining weight, it could be a result of a medication-induced hormone alteration.
  • Sedation: At some doses (generally lower ones), Geodon can be very sedating. If you feel sedated, it can be difficult to get out of bed, let alone get proper exercise. Assuming your diet has remained stable (and/or increased), you are likely to gain weight as a result of the sedation.
  • Slowed metabolism: This medication is unlikely to slow your metabolism, but may have different effects based on the individual. If you notice that your exercise habits and portion sizes are the same during treatment as they were prior to taking the drug, and you’ve gained weight – it could be a result of metabolic slowing.
  • Taste improvement: You may notice that your taste improves as a result of taking this medication. Some people respond to the neurotransmitter tweaks made by Geodon with an increased appetite and improved taste. When food tastes better, you’re probably going to end up eating more.

Could Geodon Cause Weight Loss?

In some cases, people may end up losing weight throughout their treatment with Geodon. Weight is most commonly lost when a person switches to this medication from a different antipsychotic like Zyprexa, a drug that is known to cause weight gain. Even if you aren’t switching from another medication, you may experience various side effects that lead to temporary weight loss.

  • Appetite decrease: Some people may notice that their appetite decreases while taking this drug. If your appetite decreases, you probably aren’t going to eat as much food, leading to weight loss. Although it’s not that common for appetite to significantly decrease, it does happen to some people.
  • Diarrhea: This is a side effect that some people experience while taking this drug. It’s not a common side effect, but if you end up with diarrhea, you’ll likely lose some weight. Once your body adapts to the drug and the diarrhea subsides, the weight loss shouldn’t continue.
  • Energy increase: At certain dosages, this drug tends to be more activating than sedating. This could lead to more physical activity and productivity. If you have increased energy, you’re more likely to engage in some sort of exercise. Exercise helps keep your metabolism high and is known to burn excess calories.
  • Nausea: If the drug makes you feel nauseous, it may be difficult to eat enough food. Nausea tends to subside after several weeks of treatment, but while occurring, may interfere with your ability to eat. If you are overly nauseous, your appetite is likely to temporarily decrease – resulting in weight loss.
  • Vomiting: A side effect associated with psychotropic drugs is that of vomiting. If you start vomiting while on this medication, you’re going to lose some weight. Fortunately most weight loss as a result of vomiting is “short-term.” Vomiting generally subsides once your body has adapted to the effects of the drug; this can take several weeks.

Factors that influence weight changes on Geodon

There are several other factors that may be responsible for weight changes you experience while taking Geodon. These include things such as: genetics, your personal habits, how long you’ve been taking the drug, your dosage, as well whether you take other medications.

1. Genetics

Realize that each person has different reactions to medications in part due to their genetics. Although most people aren’t going to experience major weight changes while taking Geodon, those that do may have certain genetics that trigger these changes. Fortunately there are now tests like “GeneSight” available that analyze your genetics and predict your ability to tolerate psychiatric drugs like Geodon.

2. Lifestyle

Before you assume that the drug is causing your weight to fluctuate, evaluate your lifestyle and habits. Do you make an effort to eat healthy and/or get regular physical activity? Do you get enough sleep at night? Are you overstressed from work or relationships? All of these factors can influence weight changes independent of the medication.

It is important to consider something as simple as lack of sufficient sleep can cause certain people to gain weight. Always take an objective look at your lifestyle and determine whether your habits are contributing to weight gain. Also keep in mind that some people change their routine after they start this medication, which may result in weight change.

3. Duration of treatment

The duration over which you’ve been taking Geodon may play a role in determining weight gain. Those that have been on the drug for an extended period of time are more likely to experience some degree of weight change. This is due to the fact that after a long-term of being medicated, the drug will have altered various homeostatic physiological functions within the body.

Many of these physiological functions may help regulate appetite, hormones, and metabolism. If you notice that you’ve lost or gained weight over the long-term, it may be due to the fact that you are further from your baseline, homeostatic functioning. Also keep in mind that some people may experience weight changes over the short-term as their body adapts to the drug. Short-term weight changes tend to subside once a person stabilizes on the medication.

4. Dosage

For medications that cause weight change, there is often a relationship between degree of weight change and dosage strength. For some medications, the greater the dose, the more inclined a person will be to gain weight. On other medications, there is no apparent relationship between dosing and weight change. With Geodon, it is believed that different doses have different effects based on the individual.

  • Low doses: Some have suggested that lower doses of Geodon tend to be more sedating than higher ones. If the sedation causes you to become lazier and you end up maintaining your current appetite, metabolism may slow, ultimately leading to weight gain. Others would argue that the lower the dose, the easier it is to prevent weight change of any type. This is because at lower doses, the drug has less influence over your physiology. Therefore, it is always recommended to take the “minimal effective dose.”
  • Higher doses: At higher doses of Geodon, the drug can be activating in that it provides the user with more energy. Increased energy can give people fuel to exercise, move around, and keep their metabolism high. On the other hand, at higher doses, the chemical has more influence over physiological functions. Some would argue that higher doses are more likely to cause weight changes.

5. Other drugs

Do you currently take any other medications with Geodon? If you are on a stack of several medications, it is important to consider the possibility that the other drugs may be contributing to weight change. As a rule of thumb, most stimulatory drugs tend to promote weight loss, while sedating agents and various antidepressants (e.g. SSRIs) can cause weight gain. If you are unsure as to how other drugs you are taking could be affecting your weight, talk to your doctor. Also keep in mind that the other medications you take could interact with Geodon’s mechanism of action to provoke weight change.

How much weight change will you experience on Geodon?

Most people will not experience any noticeable weight change from taking this medication. If you meticulously weigh yourself, you may notice very small changes as a result of treatment, but for a majority of people, they tend to be minimal. For those that do experience weight change, it may occur early in treatment when the body hasn’t yet adapted to the effect of the drug.

Once the body adapts to its effect, your weight should stabilize. In other cases, those taking the medication for a long-term may notice weight change stemming from physiological tolerance. If you do experience weight gain or loss, it will likely range between 5 lbs. and 15 lbs. – it shouldn’t be anything too extreme.

Geodon’s therapeutic effects vs. side effects

If you are taking this medication, it is important to evaluate how well it is working, and compare the therapeutic effects with the side effects. If the side effects become unbearable, you’ll probably want to consider Geodon withdrawal and/or another medication. Assuming the drug is working well to treat your psychiatric condition, you may be able to put up with some minor weight gain (or loss) throughout treatment.

Did you experience weight changes on Geodon?

If you took (or are currently taking) Geodon, feel free to share whether you gained (or lost) weight in the comments section below. For those that experienced any type of weight changes on this drug, feel free to mention how many pounds you gained (or lost). To help others get a better understanding of your experience, include additional details such as: your dosage, how long you were taking this drug, whether you were on other medications, and any other factors that may have elicited weight change.

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{ 7 comments… add one }
  • Emily October 5, 2015, 5:26 am

    I have just started 20mg of Geodon. I am at least a week in and I have lost about five pounds give or take. My appitite has deceased and my energy levels are higher than before. I hope that this drug continues to be wonderful.

  • Jennifer November 5, 2015, 6:15 am

    I’ve been using geodon for about 2 months and I’ve gained 15+ pounds. And I take adderall, so without the Adderall, I can’t even imagine how much more I would’ve gained.

  • Angela December 8, 2015, 11:22 am

    I have been taking geodon for about two weeks now and have lost 10 of the 50 pounds I gained on risperdal. I hope it keeps up. My appetite has decreased significantly (which is good).

  • Autumn December 25, 2015, 12:49 am

    I have been taking Geodon for about three weeks now and of course I am sensitive to the weight gain effect so I have gained about 5 lbs. I am going to talk to the doctor about adding dexedrine to help my ADHD or switching to topamax. I have heard that it helps you lose weight and is better at treating bipolar 2.

  • liv July 6, 2016, 8:28 pm

    I have lost 25 pounds in the 6 months of taking geodon. I gained 90 pounds on risperidone. I did manage to lose 15 pounds on risperidone when I began counting my calories. To lose weight on geodon I eat 1200 calories of healthy food a day, walk for an hour a day, do 20 minutes on the elliptical and strength training. I am hoping to lose the other 60 pounds I gained on risperidone. On geodon I don’t lose any weight unless I am counting my calories and exercising. If I can’t lose the rest of the weight on geodon I am going to try topamax or lithium orotate.

  • Amy September 7, 2016, 4:04 pm

    I’ve been on this drug for a month after being on seroquel 600mg for 7 yrs. I take 80 mg twice daily. Coming off seroquel was a nightmare. However, I’m starting to adjust to geodon and have lost 15lbs. I do have issues with insomnia on this drug, but should go away over time.

  • Erika October 24, 2016, 10:02 pm

    On Geodon, I lost 10 lbs but gained back about 4 lbs in about 5 months. This was not before embarking on a rigorous half marathon training plan that had me exercising on average 5 days per week at high endurance (1-4 hours) and high intensity, with cross training and weight training twice a week. I am guessing this exercise had to do with losing the 10lbs, but not much more than that amount of weight since marathoners and half marathoners tend to gain some weight while training by eating to compensate for the amount of carbohydrates and glycogen the body expends.

    Some background info: I sleep 8-9 hours per night soundly and have not experienced any huge changes in appetite or energy levels not due to intensive exercise. I had previously been on Abilify for a year (for Bipolar I) which was the only lifestyle change that could’ve caused me to gain between 40 and 50 lbs within less than three months!! The ten pound drop is a welcome change but frankly it is not enough for me to be at what I consider my healthy weight again.

    I am hoping someone here can shed some light, as I have been off of the Abilify for nearly 6 months now and on Geodon ever since, which is supposed to have no weight side effects. I know I am healthy since I am a long distance athlete but I wonder about long term health effects of having 40 lbs of weight on me that simply weren’t there before. And simply won’t go away. Thanks in advance.

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