Geodon (Ziprasidone) is an atypical antipsychotic drug that was developed to treat schizophrenia. It is also used to help control acute mania and treat mixed states among individuals with bipolar disorder. In some cases this drug is prescribed as an off-label treatment for depression, anxiety, autism, PTSD (post-traumatic stress disorder), OCD (obsessive compulsive disorder), and aggression. The drug comes in oral (pill) form as well as an injection (intramuscular) form.
It works primarily on the dopamine and serotonin receptors, but also has a fair effect on adrenergic and histamine receptors. It should be noted that it can inhibit the reuptake of serotonin and norepinephrine, but not dopamine. It is thought that Geodon works well for treating positive symptoms of schizophrenia (e.g. hallucinations) because it acts as a D2 dopamine receptor antagonist as well as a blockade at the 5-HT2A receptor.
It is thought that the effects the drug has on serotonin receptors also may reduce negative symptoms of schizophrenia. Although this is a drug that may work well for many people, there often comes a time when an individual wants to withdraw from the medication. Reasons for withdrawal include: a desire for “natural” functioning, unbearable side effects, and/or minimal benefit from taking the drug.
Factors that influence Geodon withdrawal
Below are various factors that influence a person’s withdrawal from Geodon. These factors include: time span over which the person took the drug, dosage, how quickly the person tapered from the drug, and other individual factors such as: environment, social support, etc.
1. Time Span
How long did you take Geodon? In general, the longer you took this medication, the more difficult it will be to withdraw. People that have taken this drug for years may experience severe symptoms at even slight reductions in dosage. In cases of people who haven’t been on the drug for a long term, the withdrawal symptoms may be relatively minimal.
2. Dosage (20 mg to 100 mg)
Most people taking Geodon for schizophrenia will start out at an initial dose of 20 mg twice daily. Over time, a person may gradually titrate their dosage upwards until they have successfully managed their symptoms. In most cases, people will be taking anywhere from 20 mg to 80 mg, twice daily. However, in some cases, people end up taking up to 100 mg twice per day.
There is no clinical evidence in support of dosages that exceed 80 mg twice per day. In reference to withdrawal, the greater the dose that you take, the tougher it’s going to be to withdraw. When you titrate upwards to a relatively high dose, your body becomes accustomed to receiving high quantities of the drug. When withdrawing from a high dosage, the withdrawal symptoms are usually more severe than quitting from a lower dose.
3. Cold Turkey vs. Tapering
It is never recommended to quit an antipsychotic drug “cold turkey.” If you quit cold turkey, it is thought that the acute withdrawal symptoms will be increasingly severe. Additionally, cold turkey withdrawals may lead to a protracted or post-acute withdrawal (i.e. experiencing symptoms for months after your last dose).
It is always recommended to work closely with your psychiatrist or someone knowledgeable in recognizing withdrawal symptoms from this medication. To reduce the severity of withdrawal, your tapering period should be based on the amount of time you have been on the drug as well as your current dosage. The slower the taper, the easier it is for your body and brain to gradually readjust to functioning without the drug.
Most people that have come off of the drug gradually reduce their dose by 20 mg every 2 weeks. If you try this method and are noticing that the withdrawal effects are too difficult to cope with, you could taper by 10 mg every 2 weeks or 20 mg every month. Go at a rate that you feel is slow enough to reduce symptoms.
4. Individual Factors
There are also individual factors that will play a role towards influencing your withdrawal. These factors include things like: whether you take other medications, whether you are transitioning to a new drug, your sleep patterns, environmental stressors, dietary and exercise habits, etc.
It should also be noted that some individuals have an easier time coping with withdrawals than others. One person may have a low sensitivity to withdrawal symptoms, while another person may feel as if each day of withdrawal is pure hell.
Geodon Withdrawal Symptoms: List of Possibilities
Below is a list of withdrawal symptoms that people experience upon discontinuation of Geodon. Keep in mind that you may not experience all of these symptoms and that the severity of symptoms differs based on the individual. Some people will experience more severe symptoms and more overall symptoms than others when they quit the drug.
- Anxiety: During withdrawal, the anxiety that you experience may be overwhelming. In order to reduce overwhelming sensations of anxiety, it is important to taper slowly. You will need to be prepared to deal with some anxious thinking so do your best to realize that it will eventually reduce as weeks and months pass.
- Chills: Many individuals report feeling “chills,” cold sensations, and shivering when they discontinue. These can be uncomfortable, but the symptoms are a result of your body detoxifying itself from the drug that you were taking.
- Concentration problems: Don’t be surprised if you have difficulty concentrating on work-related tasks during the first few weeks of withdrawal. You may experience major brain fog and when accompanied by other withdrawal sensations, it can be very difficult to even think, let alone work for 8 hours.
- Confusion: Many people experience a combination of brain fog and memory deficits upon withdrawal that leads them to feel “confused.” If you experience confusion, it should improve over the next few months.
- Crying spells: If you become severely depressed when you stop taking this medication, you may end up having periods of crying spells. This surge in depressed emotion that leads to crying is usually a sign of abnormally low levels of various neurotransmitters.
- Depression: You may fall into a deep depression when you initially quit taking this drug. The depression is a result of your brain trying to regulate neurotransmitters without the influence of Geodon. As time passes, your brain will restore normative activity and your mood should improve.
- Dizziness: If you feel dizzy during withdrawal, you are certainly not alone. This is perhaps the most common symptom for people to experience when withdrawing from any psychiatric drug. The dizziness should gradually improve, but may be severe in the first few weeks of withdrawal.
- Fatigue: If you feel especially lethargic, tired, and low energy, this is a result of withdrawal fatigue. You may feel as though you lack the energy it takes to get out of bed in the morning. If you push yourself though and keep doing what you can, your energy levels should consistently improve.
- Flu-like symptoms: The combination of hot flashes, cold chills, dizziness, headache, vomiting, and nausea can make withdrawal feel similar to the flu.
- Headache: It is extremely common to have headaches during the initial few weeks of which you withdraw. In order to reduce headaches, be sure to stay hydrated, get plenty of rest, practice relaxation exercises, and consider over-the-counter headache relief.
- Hot flashes: Some have reported experiencing hot flashes during the first week or two of withdrawing. These shouldn’t last longer than a month.
- Insomnia: People have reported extreme periods of insomnia upon discontinuation from this medication. Therefore to minimize insomnia as much as possible, it is important to taper very slowly. To reduce insomnia consider melatonin, exercise, and/or relaxation techniques.
- Memory problems: It is common to experience memory problems upon discontinuation from an antipsychotic drug. You may experience difficulties with both short-term and long-term memory retrieval. These should gradually improve over time, so don’t panic if they don’t immediately improve.
- Mood swings: Withdrawing from any psychiatric drug can lead a person to experience mood swings. They may be difficult to deal with at times because your brain is highly sensitive and neurotransmitter levels are trying to restore themselves. One minute you may feel highly anxious, the next tired and depressed. Do your best to put up with these swings and they should gradually improve throughout your withdrawal.
- Muscle weakness: If you experience muscle weakness, aches, and cramps, these are very normal. It may take some time for your body to regain energy and strength after your withdrawal. Any muscle weakness should improve within a few months.
- Nausea: Feeling intense nausea is common during the first few weeks of withdrawal. In many cases the nausea is so severe that it leads to vomiting.
- Palpitations: If you notice changes in heart rhythm, these are known as palpitations. You may experience sensations of abnormal heartbeats and/or pounding in your chest.
- Panic attacks: Another fairly common symptom upon withdrawal is that of panic attacks. Your arousal level may be higher than normal and you may experience intense anxiety. This anxiety may lead to panic attacks if you are unable to relax. These will not be permanent if you had not experienced them before the medication, but they may take awhile to go away.
- Psychosis: It has been documented that withdrawing from antipsychotics can cause psychosis. This means that you may experience hallucinations (e.g. hearing voices) and delusions as a result of chemical changes in the brain that occur during withdrawal. If you do not have schizophrenia, it is probably just a withdrawal symptom. If you have schizophrenia, this may signify a relapse.
- Restlessness: You may feel unable to sit still and extra restless during the discontinuation process. Consider utilizing relaxation techniques to help lower arousal and increase calmness.
- Shaking: Other people have experienced the “shakes” and/or tremors during withdrawal.
- Sleep changes: Most people experience some sort of changes in their sleep quality and/or patterns when coming off of this drug. You may experience nightmares, poor sleep quality, and/or inability to stay asleep. This should improve as time continues to pass.
- Suicidal thinking: This is a very normal symptom to experience during withdrawal from any psychiatric medication. Feeling depressed and suicidal after using a medication for a long period of time is because your neurotransmitter levels have been altered by the drug. They will need some time to recover. Consider seeking a professional psychotherapist for emotional support if you feel suicidal.
- Sweating: Having sweats is thought to be a natural byproduct of your body going through detoxification. You may notice that you sweat more than normal throughout the day or while you sleep.
- Vomiting: Most people that report vomiting usually have to deal with it for about a week. This is typically only a symptom that occurs during the acute stage of withdrawal.
- Weight loss: If you experienced weight gain while taking Geodon, you should lose the weight that you packed on while taking it. Although many experts consider it “weight neutral” the fact is that some individuals gain a fair amount of weight while taking it.
Geodon Withdrawal Duration: How long does it last?
Most people report that their symptoms resulting from Geodon withdrawal last up to several months. It should be noted that if you were on Geodon for a very short duration and/or were taking a relatively low dose, you may experience less severe and persistent symptoms. Individuals that quit taking this drug “cold turkey” or those who tapered too quickly are thought to have a longer lasting withdrawal.
Those who have been taking this antipsychotic for an extended period of time may report that their discontinuation symptoms last up to 6 months. I recommend keeping documentation of symptoms upon withdrawal and reevaluating them every 3 months (i.e. 90 days). By giving yourself 3 months to reevaluate, you are giving your brain and body time to slowly readjust back to homeostatic functioning.
Many people require longer than 3 months to experience full recovery from withdrawal. As mentioned, you may not recover at the same rate as other people based on individual factors. One individual reported that in his experience it took a full 5 months for him to feel 90% better (in his subjective estimation). If you have gone through Geodon withdrawal and/or are currently going through with discontinuation, feel free to share your experience – you may really help someone else.