Ziprasidone
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Ziprasidone is an atypical antipsychotic used for schizophrenia and bipolar I manic or mixed episodes. It has a clinically important QT-prolongation profile and oral absorption is strongly food dependent. Like other antipsychotics, it carries a boxed warning for increased mortality in elderly patients with dementia-related psychosis.
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What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Ziprasidone is an atypical antipsychotic used for schizophrenia and bipolar I manic or mixed episodes. NutriStack rates the supporting evidence as strong. Common adult dosing is Schizophrenia: typically 20 mg twice daily with food, titrated up to 80 mg twice daily. Bipolar mania: commonly 40 mg twice daily on day 1, then 60-80 mg twice daily with food., though a prescriber sets the actual dose. This profile indexes 3 sources.
- Somnolence
- Dizziness
- Akathisia
- Known QT prolongation2
- Recent acute myocardial infarction
The bottom line
Evidence rating strong. Most-documented uses: treatment of schizophrenia in adults, acute treatment of manic or mixed episodes in bipolar i disorder, maintenance treatment of bipolar i disorder as adjunct to lithium or valproate. 3 sources indexed (2020–2025), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Ziprasidone antagonizes dopamine D2 and serotonin 5-HT2A receptors and also has activity at several other serotonin receptors, with modest serotonin and norepinephrine reuptake inhibition. Antipsychotic and antimanic effects are primarily attributed to dopamine and serotonin receptor modulation. Its QT-prolonging effect is related to cardiac repolarization effects, so electrolyte abnormalities and other QT-prolonging agents increase arrhythmia risk.2,3
Dosing & protocol.
Food increases oral ziprasidone absorption up to about two-fold. Taking doses without a meal can substantially reduce exposure.2
Full safety detail.
Side effects
- Somnolence
- Dizziness
- Akathisia
- Extrapyramidal symptoms
- Nausea
- QT prolongation
- Orthostatic hypotension
- Hyperglycemia and dyslipidemia
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Seizures in susceptible patients
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Reviews & position papers
1- 1The American Psychiatric Association practice guideline for the treatment of patients with schizophreniaAmerican Psychiatric Association · American Journal of Psychiatry · 2020
Guideline supports antipsychotic monitoring for movement disorders, metabolic effects, and cardiovascular risk.
Reference material
2- 2ZIPRASIDONE capsules, US Prescribing InformationURLU.S. National Library of Medicine · DailyMed · 2025
Generic labeling emphasizes dose-related QT prolongation and contraindication with specified QT-prolonging drugs.
- 3GEODON (ziprasidone) capsules and injection, US Prescribing InformationURLPfizer Inc. · DailyMed · 2024
Labeling documents food-dependent absorption, QT contraindications, dosing, and the dementia-related psychosis boxed warning.
Common questions.
Quick answers about Ziprasidone, drawn from the data on this page.
What is Ziprasidone?
Ziprasidone is an atypical antipsychotic used for schizophrenia and bipolar I manic or mixed episodes. It has a clinically important QT-prolongation profile and oral absorption is strongly food dependent. Like other antipsychotics, it carries a boxed warning for increased mortality in elderly patients with dementia-related psychosis.
What is Ziprasidone used for?
Commonly cited benefits of Ziprasidone include: Treatment of schizophrenia in adults; Acute treatment of manic or mixed episodes in bipolar I disorder; Maintenance treatment of bipolar I disorder as adjunct to lithium or valproate; Intramuscular treatment of acute agitation in schizophrenia. NutriStack rates the overall evidence as strong.
What is a typical dose of Ziprasidone?
A typical adult dose of Ziprasidone is Schizophrenia: typically 20 mg twice daily with food, titrated up to 80 mg twice daily. Bipolar mania: commonly 40 mg twice daily on day 1, then 60-80 mg twice daily with food.. The commonly recommended form is Oral capsule taken twice daily with food; intramuscular injection for acute agitation. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Ziprasidone?
Reported side effects include somnolence, dizziness, akathisia, extrapyramidal symptoms, nausea, qt prolongation. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Ziprasidone?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Ziprasidone in NutriStack.
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