What is ziprasidone?

The treatment of bipolar disorder is complex due to the presence of varying configurations of symptoms in patients. The primary treatments for bipolar disorder are pharmacological, and often involve antipsychotic drugs such as the second-generation antipsychotic, ziprasidone.

What is the evidence for ziprasidone as treatment for bipolar disorder?


Moderate quality evidence suggests small to medium-sized effects of better improvement in acute mania symptoms with ziprasidone than with placebo or topiramate, although there was better improvement in mania symptoms with tamoxefin than with ziprasidone.

Moderate to low quality evidence finds no differences in acute depression between ziprasidone and placebo. Moderate quality evidence suggests no differences in depression symptoms, response or remission between low (40-80 mg) and high (120-160 mg) dose ziprasidone.

Moderate quality evidence suggests greater improvement in clinical global impression, depression symptoms, response to treatment, and remission with lurasidone than with ziprasidone.

Also see the topics on relapse prevention and polypharmacy.

Side effects

Compared to placebo, moderate quality evidence suggests an increased risk of more prolactin, hyperkinesia, akathisia, muscle weakness, somnolance and sedation with ziprasidone, with no differences in insomnia, agitation or weight gain.

Moderate to low quality evidence suggests lower risk of switching to mania with ziprasidone than with aripiprazole or lamotrigine. There are no differences in rates of switching to depression between ziprasidone and haloperidol.

Moderate quality evidence suggests more somnolence with ziprasidone than with lurasidone.

November 2021

Image: ©Karl Thomas –

Last updated at: 2:50 pm, 1st December 2021
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