What is the recommended dose of Ziprasidone (Geodon) for acute agitation?

From the Guidelines

Ziprasidone (Geodon) is recommended for acute agitation at a dose of 20 mg intramuscularly, as it has been shown to be effective in rapidly and substantially reducing symptoms of acute agitation with minimal side effects, including extrapyramidal symptoms, dystonia, and hypertonia 1.

Key Considerations

• The efficacy of the 10-mg dose is not as great as the 20-mg dose, although it is significantly better than a 2-mg dose 1.
• Ziprasidone 20 mg IM has been found to be well-tolerated and effective in reducing symptoms of acute psychosis, with a lower incidence of movement disorders compared to haloperidol IM 1.
• The medication should be used with caution in patients with heart conditions, as it can prolong the QT interval, and an ECG should be considered before initiating treatment 1.

Dosing and Administration

• The recommended dose of Ziprasidone (Geodon) for acute agitation is 20 mg intramuscularly, which may be repeated as needed, up to a maximum of 40 mg daily.
• For oral administration in agitation, typical dosing ranges from 20-80 mg twice daily, with food to enhance absorption.

Safety and Monitoring

• Common side effects include sedation, dizziness, and prolongation of the QT interval.
• Geodon should not be used with other medications that prolong the QT interval, and electrolyte abnormalities should be corrected before administration.
• Patients should be monitored for signs of cardiac arrhythmias, and an ECG should be performed before initiating treatment, especially in patients with pre-existing heart conditions 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Acute treatment of agitation associated with schizophrenia (intramuscular administration): 10 mg - 20 mg up to a maximum dose of 40 mg per day. Doses of 10 mg may be administered every 2 hours. Doses of 20 mg may be administered every 4 hours.

The recommended dose of Ziprasidone (Geodon) for acute agitation is 10 mg - 20 mg up to a maximum dose of 40 mg per day, with dosing intervals of every 2 hours for 10 mg doses and every 4 hours for 20 mg doses 2.

From the Research

Recommended Dose of Ziprasidone for Acute Agitation

• The recommended dose of Ziprasidone (Geodon) for acute agitation is not explicitly stated in the provided studies, but the effective doses used in the studies are:
  • 20 mg IM, as shown in the study 3, which demonstrated significant reduction in agitation and improvement in psychotic symptoms.
  • 10-20 mg IM, as used in the study 4, which compared the efficacy and tolerability of IM ziprasidone with haloperidol IM.
• The study 5 compared the effectiveness of 10 mg and 20 mg of ziprasidone IM, and found that 20 mg was more effective in reducing acute agitation.

Efficacy and Safety of Ziprasidone

• Ziprasidone IM has been shown to be effective in reducing acute agitation and improving psychotic symptoms, with a rapid onset of action (within 15-30 minutes) 6, 3.
• Ziprasidone IM has a favorable tolerability profile, with a lower incidence of movement disorders and extrapyramidal symptoms compared to haloperidol IM 4, 7.
• The combination of ziprasidone IM with benzodiazepines has been shown to be safe and effective in clinical trials 6.