Ziprasidone

Key facts

• Ziprasidone is an atypical antipsychotic used for schizophrenia and for acute manic or mixed episodes of bipolar disorder, taken as capsules twice daily.
• It must be taken with food, at least 500 calories, because food substantially increases how much of the dose your body absorbs.
• Ziprasidone prolongs the heart's QT interval more than many other antipsychotics, raising the risk of a dangerous irregular heart rhythm. It should be avoided in people with existing QT prolongation or combined with other QT-prolonging drugs.
• Seek urgent care for fainting, palpitations, or a high fever with muscle stiffness and confusion.

What ziprasidone treats

Ziprasidone treats schizophrenia and acute manic or mixed episodes of bipolar I disorder. An injectable form is used for acute agitation in schizophrenia. It is not approved for treating behavioral symptoms of dementia in older adults, a group in which antipsychotics carry an increased risk of death.

How ziprasidone works

Ziprasidone blocks dopamine and serotonin receptors in the brain, rebalancing the neurotransmitter activity that is disrupted in psychosis and mania. This reduces hallucinations, delusions, and mood instability, though the full effect builds over days to weeks.

Before you take it

• Avoid ziprasidone if you have known QT prolongation, a recent heart attack, or uncompensated heart failure.
• Tell your prescriber about any other QT-prolonging medicines you take, such as certain antibiotics, antiarrhythmics, or antihistamines.
• Correct low potassium or magnesium levels before starting, since these raise the risk of an abnormal heart rhythm.
• Always take ziprasidone with a substantial meal to ensure proper absorption.

Side effects

Common effects include drowsiness, dizziness, nausea, restlessness, and headache.

Stop and seek urgent medical care for any of these:

• Fainting, palpitations, or an irregular heartbeat.
• High fever with muscle rigidity and confusion, which can signal neuroleptic malignant syndrome.
• Uncontrollable muscle movements or sudden muscle stiffness.
• Severe allergic reaction, such as swelling or difficulty breathing.

Safety essentials

• QT prolongation is ziprasidone's defining risk. Always take it with food, avoid combining it with other QT-prolonging medicines, and have an ECG or electrolyte check if your prescriber advises it.
• Correct low potassium or magnesium before and during treatment.
• Watch for neuroleptic malignant syndrome: fever, muscle rigidity, and confusion require emergency care.
• Ziprasidone is not for treating behavioral symptoms of dementia in older adults, due to an increased risk of death in that group.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.