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 Schizophrenia: Medications
 Ziprasidone (Geodon)
 Maximum dose of Ziprasidone
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lclosama
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Posted - 12/04/2007 :  07:00:00  Show Profile  Reply with Quote  Reply to Topic
I've been told that the maximum dose of Ziprasidone is 320mg (although the FDA says it's 160mg), is that true?

Thanks,
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OWLman
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Posted - 07/27/2009 :  14:23:50  Show Profile  Reply with Quote  Reply to Topic
As far as I know, 160mg per day is the maximum dose; both the FDA and Health Canada do not endorse exceeding this dose. According to various sources, exceeding 160mg per day increases the risk of acquiring Torsade de Pointes - a dangerous heart condition that can be fatal. The heart's QT interval can be prolonged by ziprasidone (ZELDOX), and it appears to be positively correlated with the dose.

It should be noted that many psychiatric drugs - most notably SSRI's - have a "flat dose response curve That is, the drug either works or it does not (usually at a moderate dose) - and above the therapeutic dose, it will not work any better. Thus, exceeding the therapeutic dose will NOT increase the beneficial effects of the drug, and can - in fact - increase the risk of side effects.

Hope this answers your question.
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Chris
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Posted - 07/28/2009 :  02:37:57  Show Profile  Reply with Quote  Reply to Topic
wow OWLman, that's really fascinating I never knew that about a medications response curve.

Anarchy and Peace
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hercules21
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Posted - 08/01/2009 :  00:42:28  Show Profile  Reply with Quote  Reply to Topic
A lot of doctors believe strongly in upping the dose when it isn't working at a medium dose. I kind of agree if it isn't going to work at 2/3 of the maximum then it probably isn't going to work at the full dose.
On the other hand from memory I think some of our members have had less symptoms when their doctor has totally cranked up the dose. Just based on what they said.

In terms of answering the original question I have heard of the odd person taking more than 160mgs but I personally wouldn't want to exceed this dose.

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OWLman
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Posted - 08/01/2009 :  14:31:32  Show Profile  Reply with Quote  Reply to Topic
Almost every doctor I have been treated by has upped the dose of medication if the initial dose has not met with an adequate response. With the exception of amitriptyline, I have not personally found this effective with any psychiatric medication.

As matter of fact, I can point to my own experience with Seroquel as anecdotal evidence that dose escalation does not necessarily boost the therapeutic effects of a drug. In my case, the doctor upped the dose from 500mg qd to 900mg qd; this actually INCREASED my psychotic symptoms (it also made me extremely jittery and nauseous I could not eat anything for days on end without vomiting). Eventually, I had to discontinue the drug entirely.

I know that everyone reacts differently to all types of medication, including antispychotics and antidepressants. A drug and or dose that works for one person may or may not work for another. I guess our bodies and brains are all wired a little differently. However, my own experience has shown me that escalating the dose of a medication tends to increase the SIDE EFFECTS more than it improves the therapeutic benefit. Thus, in my opinion, pushing up to and or/exceeding the maximum recommended dose of medication will result in the risks of the medication outweighing it's benefits.


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