Geodon Tapering Guide
ziprasidone
Boxed Warning
Increased mortality in elderly patients with dementia-related psychosis.
Overview
Ziprasidone is an atypical antipsychotic for schizophrenia and acute mania. Lower metabolic burden than most atypicals but among the highest QT-prolongation risks in the class. Must be taken with food (≥500 calories) for proper absorption.
20mg, 40mg, 60mg, 80mg capsules; 20mg/mL injection (IM)
Capsules: 20mg, 40mg, 60mg, 80mg; IM injection: 20mg/mL
Category C
Mechanism of Action
D2 antagonist; potent 5-HT2A antagonist; some serotonin-norepinephrine reuptake inhibition; 5-HT1A partial agonism.
Taper Notes
Slow taper, with food. ECG check if cardiac history.
Hyperbolic Tapering Guidance
Lower metabolic burden than olanzapine/quetiapine but distinctive cardiac considerations. Tardive risk applies to all dopamine antagonists.
Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.
Withdrawal Timeline
2-5 days
1-2 weeks
2-4 weeks
Tardive symptoms can emerge weeks-to-months after taper
Common Withdrawal Symptoms
Interactions & Safety
Drug Interactions
- Other QT-prolonging drugs — contraindicated
- CNS depressants — additive sedation
Contraindications
- QT prolongation, recent MI, uncompensated heart failure
- Concurrent QT-prolonging medications
Toxicity
QT prolongation (highest among atypicals), sedation, akathisia, EPS, NMS, rash (Stevens-Johnson rare), tardive dyskinesia.
Pharmacokinetics
ADME Profile
Hepatic via aldehyde oxidase (major) and CYP3A4 (minor).
>99%
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Other Drug Profiles
Sources & References
Geodon (ziprasidone) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.
Encyclopedic & chemical databases
Neutral, high-authority entity references.
Regulatory sources
Official prescribing information and safety notices.
Peer-reviewed research
Primary literature cited in this taper guide.
- Horowitz MA, Jauhar S, Natesan S, Murray RM, Taylor D 2021 — A method for tapering antipsychotic treatment that may minimize the risk of relapse (Schizophrenia Bulletin)
- Tranter R, Healy D 1998 — Antipsychotic withdrawal symptoms: phenomenology and pathophysiology (Journal of Psychopharmacology)
- Davies J, Read J 2019 — A systematic review into the incidence, severity and duration of antidepressant withdrawal effects (Addictive Behaviors)
Clinical guidelines
Evidence-based deprescribing and prescribing standards.
Deprescribing-specific resources
Clinician-facing references on tapering protocols.
- Royal College of Psychiatrists — Antipsychotics — UK clinical guidance on antipsychotic prescribing and discontinuation
- Council for Evidence-Based Psychiatry (CEP UK) — Evidence-based critique of long-term antipsychotic prescribing
- Deprescribing.org — Antipsychotic deprescribing algorithm for insomnia and BPSD
Patient-advocacy & lived-experience
Long-running communities documenting withdrawal experience.
- Surviving Antidepressants — antipsychotic tapering forum — Community archive of antipsychotic taper experiences
- Mad in America — antipsychotic archive — Independent journalism on antipsychotics and withdrawal
- Inner Compass Initiative — Withdrawal Project — Peer-led psychiatric drug withdrawal resources
- RxISK — adverse drug reaction reporting — Independent database of antipsychotic adverse-effect reports
TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.