9 Geodon Side Effects To Know About

Geodon (ziprasidone) is part of a group of medications called atypical antipsychotics. It’s FDA approved to treat bipolar 1 disorder and schizophrenia in adults. It works by balancing out certain chemicals in the brain, such as dopamine and serotonin. This can positively affect your mood, thoughts, and behavior.

As with all medications, Geodon has risks to be aware of. Although Geodon side effects are often mild, severe problems may rarely occur. So it’s important to watch for any symptoms that may indicate you’re experiencing a side effect.

Good to know: Geodon comes as an oral capsule and an injection that’s administered into your muscles by a healthcare professional. In this article, we’ll focus only on oral Geodon.

Geodon side effects at a glance

Geodon can cause a number of side effects. The most common Geodon side effects include:

• Sleepiness

• Movement-related problems

• Respiratory infections

• Dizziness

• Nausea or vomiting

• Lack of energy

• Weight gain

• Vision changes

• Muscle pain

Rare but serious side effects include:

• Uncontrolled muscle movements (tardive dyskinesia)

• Heart rhythm problems

• Neuroleptic malignant syndrome (NMS)

• Increased cholesterol or blood glucose (sugar)

• Falls, leading to injuries or bone fractures

• Seizures

• A decrease in your white blood cells

• Severe medication reactions like Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and Stevens-Johnson syndrome (SJS) 

Here, we’ll take a closer look at nine Geodon side effects.

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1. Sleepiness

Sleepiness is a common Geodon side effect. Sleepiness may improve within the first few weeks of starting Geodon as your body adjusts to the medication. But if sleepiness is impacting your day-to-day life, there are a few things to consider:

• Make sure you have good sleep hygiene. There are many things you can do to improve your sleep. Examples include avoiding screens before bedtime and having a consistent bedtime and wake-up routine.

• Avoid other medications that cause drowsiness, if possible. Combining Geodon with medications that make you tired can worsen drowsiness. Give your prescriber and pharmacist a list of medications you take. They’ll check if any of your other medications cause drowsiness.

• Talk to your prescriber about your Geodon dose. Higher Geodon doses may be more likely to cause sleepiness. You may need a lower dosage if your sleepiness is significantly impacting your life. But don’t make any changes without talking to your prescriber first.

2. Movement problems

Geodon can cause repetitive or uncontrolled muscle movements. These are called extrapyramidal symptoms (EPS). EPS can refer to various movement-related problems, including:

• Restlessness or inability to sit still (akathisia)

• Muscle contractions that cause twisting of your body (dystonia)

• Tremors

• Twitching

In rare cases, Geodon can cause a more severe condition called tardive dyskinesia (TD). Symptoms of TD include uncontrolled muscle movements of the face, mouth, and tongue. It may also involve rocking side to side or arm swinging.

If you experience signs of TD, let your prescriber’s office know immediately. They may recommend medications that can help ease your symptoms. Or they may suggest changing your medication. It’s possible that stopping Geodon will cause TD to go away, but that’s not always the case.

TD is more likely with long-term use and higher doses of atypical antipsychotics. So it’s best to take the lowest dose possible of Geodon.

3. Respiratory infections

Upper respiratory infections (like the common cold) are possible with Geodon. Symptoms of an upper respiratory tract infection include cough, sore throat, and fever.

If you’re experiencing any of these symptoms, let your prescriber’s office know. They may recommend medications or at-home treatments to help your symptoms. This may include over-the-counter (OTC) pain relievers, such as Advil (ibuprofen) and Tylenol (acetaminophen), or decongestants, such as Sudafed (pseudoephedrine). Using a neti pot or taking a hot shower or bath may also help clear your nasal passages.

4. Dizziness

Dizziness is another common Geodon side effect. Geodon can also cause orthostatic hypotension, though it’s not as common as it is with some other atypical antipsychotics. This is when your blood pressure drops as you change positions (like going from sitting to standing). Staying well hydrated while taking Geodon can help prevent dizziness. This is important because dizziness and orthostatic hypotension can make falls and injuries more likely.

When changing positions, move slowly and make sure you have something around to hold onto for support. Avoid driving and doing activities that require alertness when you first start taking Geodon or after your dose is increased. Once you see how Geodon affects you, you’ll be able to determine whether you can resume these activities.

5. Nausea

Nausea can also occur with Geodon use. It may improve as your body gets used to taking it, though.

In the meantime, you can make small lifestyle changes that may help with your symptoms. Staying well-hydrated and eating more frequent but smaller meals may help. Try avoiding spicy or high-fat foods, which may contribute to nausea. If your nausea doesn’t go away or worsens, talk to your prescriber about whether anti-nausea medications are a good option for you.

6. Higher risk of stroke and death in some older adults

There’s a higher risk of serious health outcomes — including stroke and death — in people with dementia taking antipsychotics. In fact, the FDA issued a boxed warning (the FDA’s strictest warning for medications) for Geodon regarding this risk.

But it’s important to keep in mind that using antipsychotics in older adults who need them, such as those with schizophrenia, actually reduces the risk of death. And in certain situations, people with dementia may need an antipsychotic to avoid severe problems, such as harm to themselves or others. But the American Psychiatric Association recommends this approach only when truly necessary.

7. Heart problems

Geodon can affect your heart’s electrical signals, causing a heart rhythm problem called QT prolongation (also known as long QT syndrome). This is a condition where your heart takes too long to reset between beats. QT prolongation can lead to life-threatening, abnormal heart rhythms (arrhythmia).

Geodon is one of the atypical antipsychotics that’s most likely to cause QT prolongation. However, it’s still a rare occurrence. Even if Geodon does cause QT prolongation, it’s uncommon for this to have a significant effect on your heart health.

Still, to minimize the risk of QT prolongation, some people should avoid taking Geodon. This includes people who:

• Have a history of QT prolongation

• Have certain types of heart failure, arrhythmias, or a recent heart attack

• Take certain other medications that may cause QT prolongation, such as dofetilide (Tikosyn) or sotalol (Betapace)

Before starting Geodon, share your current medication list with your healthcare team. They can check for drug interactions that may raise your risk of QT prolongation. And let them know if you have any heart-related health conditions. If you experience symptoms of QT prolongation, such as feeling faint or having a racing, irregular heartbeat, seek immediate medical care.

8. Weight gain, high blood sugar, and high cholesterol

Geodon can cause weight gain, high blood glucose, and high cholesterol. Over time, these metabolic changes can raise your risk of developing Type 2 diabetes, or worsen diabetes if you already have it. It can also increase your risk of heart disease.

Weight gain and other metabolic changes can happen at any point while taking Geodon. Eating a healthy diet and exercising regularly may help minimize these effects. If this doesn’t work, your prescriber may have other suggestions, including weight loss medications.

Monitor your weight regularly while taking Geodon and complete any lab tests your healthcare team orders for you.

9. Skin rashes

Some people taking Geodon may develop a skin rash. While this isn’t always a serious situation, let your prescriber’s office know immediately if you develop a rash while taking Geodon. They may recommend stopping Geodon.

In rare cases, a rash can be severe. If your rash is blistering, or you have a fever or swollen lymph glands with your rash, seek emergency care. These symptoms may be a sign of severe medication reactions like SJS or DRESS. These conditions can be life-threatening if not managed appropriately. 

Keep in mind that these reactions may not happen right when you start Geodon. They may begin several weeks later.

When should you contact your prescriber’s office about Geodon side effects?

If you’re experiencing Geodon side effects that impact your daily life, let your prescriber's office know. This may include drowsiness, dizziness, or nausea. Usually, these can be managed at home. But in some cases, your prescriber may adjust your dose or switch you to another medication.

If you’re experiencing severe Geodon side effects, it’s important to address these symptoms immediately to avoid any serious health problems. Seek emergency medical care for any of the following:

• Uncontrollable muscle movements

• Severe skin rash

• A racing, irregular heartbeat

• Symptoms of NMS like fever, muscle rigidity, and confusion

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Written by:

Makaela Premont, PharmD

Makaela Premont, PharmD, is a pharmacist and the founder of uniquelymickie.com, a website dedicated to helping pharmacy students and pharmacists create a life that they enjoy. She received her Doctorate of Pharmacy from the University of South Carolina and is a licensed pharmacist in North Carolina.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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