Geodon vs. Saphris for Bipolar Disorder and Schizophrenia: Important Differences and Potential Risks.

Key takeaways

Ziprasidone (Geodon) and asenapine (Saphris) are both atypical antipsychotics used to treat schizophrenia and bipolar I disorder, but they have some key differences. Ziprasidone is available in both oral and injectable forms, while asenapine is taken as a dissolvable tablet under the tongue. Ziprasidone must be taken with food twice daily, whereas asenapine dissolves quickly under the tongue and should not be chewed or swallowed. Both medications are available as lower-cost generics. Asenapine can be used in children aged 10 and older for bipolar disorder, while ziprasidone is only approved for adults. Both medications can cause weight gain, but ziprasidone is less likely to do so compared to other antipsychotics. Additionally, ziprasidone has a lower risk of causing heart rhythm problems, but it still requires caution in people with heart issues.

Ziprasidone

(Geodon)

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Asenapine

(Saphris)

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Summary for Geodon

Prescription only

Ziprasidone (Geodon) is an atypical antipsychotic medication used to treat bipolar I disorder and schizophrenia in adults. It works by balancing the levels of certain chemicals in the brain, like dopamine and serotonin. Ziprasidone (Geodon) is taken by mouth, typically twice daily. It's also available as an injection that's given into the muscles by a healthcare provider to treat agitation in schizophrenia. Some common side effects of ziprasidone (Geodon) include uncontrolled body movements, sleepiness, and nausea.

Indications for Geodon

Pros and Cons for Geodon

Pros

Taken by mouth
Less likely to weight gain than other similar medications
Available as a lower-cost generic medication

Cons

Taken twice daily
Might take several weeks before you feel the full benefits of this medication
Must be taken with food

Common Side Effects for Geodon

Uncontrolled body movements (14%)
Sleepiness (14%)
Nausea (10%)
Constipation (9%)
Indigestion (8%)
Restlessness (8%)
Dizziness (8%)
Respiratory tract infection (8%)

Note: Side effects listed were reported by people who took ziprasidone for schizophrenia in a clinical study

Warnings for Geodon

Higher risk of death in older adults with dementia-related psychosis
Risk of suicidal thoughts and behavior
Difficulty controlling muscle movements (tardive dyskinesia)
Weight gain, higher blood sugar, and higher cholesterol levels
Neuroleptic malignant syndrome
Difficulty concentrating and extreme sleepiness
Changes in blood pressure and higher risk of falls
Risk of infection (from low white blood cell count)
Seizures
Serious skin reaction
Prolonged and painful erection
High prolactin levels
Heart rhythm problems

Summary for Saphris

Prescription only

Asenapine (Saphris) is an atypical antipsychotic. It's used to treat schizophrenia in adults and bipolar I disorder in people ages 10 years and older. It comes as sublingual (under the tongue) tablets in both a brand-name and generic versions. The usual dosage is to dissolve a tablet under the tongue twice a day. Some potential side effects of this medication include sleepiness, trouble sleeping, and movement problems.

Indications for Saphris

Schizophrenia in adults
Bipolar I disorder in adults and children ages 10 years and older

Pros and Cons for Saphris

Pros

Dissolved under the tongue; good option for people who have a hard time swallowing tablets
Possible option for children who have bipolar I disorder
Less likely to cause weight gain than some other antipsychotic medications, like olanzapine (Zyprexa)

Cons

Can cause drowsiness or trouble sleeping
Taken twice a day
Can't be taken by people who have severe liver problems

Common Side Effects for Saphris

Trouble sleeping (up to 16%)
Sleepiness (up to 15%)
Movement problems (up to 12%)
Restlessness (not being able to sit still, up to 11%)
Dizziness (up to 7%)
Constipation (up to 7%)
Vomiting (up to 7%)
Mouth numbness (up to 7%)

*Note: Side effects listed above were reported by adults with schizophrenia. Similar side effects are seen in adults and children with bipolar disorder.