Ziprasidone is indicated for the following conditions-

• Schizophrenia
• Bipolar disorder
• Agitation associated with schizophrenia

Schizophrenia

Bipolar Disorder

Agitation

Ziprasidone  should be taken with food.

Schizophrenia

• Initiate at 20 mg twice daily.
• Daily dosage may be adjusted up to 80 mg twice daily.
• Dose adjustments should occur at intervals of not less than 2 days.
• Safety and efficacy has been demonstrated in doses up to 100 mg twice daily. The lowest effective dose should be used.

Acute treatment of manic/mixed episodes of bipolar I disorder: Initiate at 40 mg twice daily. Increase to 60 mg or 80 mg twice daily on day 2 of treatment. Subsequent dose adjustments should be based on tolerability and efficacy within the range of 40-80 mg twice daily.

Maintenance treatment of bipolar I disorder as an adjunct to lithium or valproate: Continue treatment at the same dose on which the patient was initially stabilized, within the range of 40-80 mg twice daily.

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.

• Schizophrenia: Somnolence, respiratory tract infection.
• Manic and Mixed Episodes Associated with Bipolar Disorder: Somnolence, extrapyramidal symptoms, dizziness, akathisia, abnormal vision, asthenia, vomiting.
• Intramuscular administration (≥5% and at least twice the lowest intramuscular ziprasidone group): Headache, nausea, somnolence.

Somnolence

Dizziness

Vomiting

Headache

• QT Interval Prolongation: Ziprasidone use should be avoided in patients with bradycardia, hypokalemia or hypomagnesemia, congenital prolongation of the QT interval, or in combination with other drugs that have demonstrated QT prolongation. 
• Neuroleptic Malignant Syndrome (NMS): Potentially fatal symptom complex has been reported with antipsychotic drugs. Manage with immediate discontinuation of drug and close monitoring.
• Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported with Ziprasidone exposure. DRESS is sometimes fatal. Discontinue Ziprasidone if DRESS is suspected.
• Tardive Dyskinesia: May develop acutely or chronically. 
• Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes that may increase cardiovascular/ cerebrovascular risk. These metabolic changes include hyperglycemia, dyslipidemia, and weight gain.
• Hyperglycemia and Diabetes Mellitus (DM): Monitor all patients for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients with DM risk factors should undergo blood glucose testing before and during treatment.
• Dyslipidemia: Undesirable alterations have been observed in patients treated with atypical antipsychotics.
• Weight Gain: Weight gain has been reported. Monitor weight gain.
• Rash: Discontinue in patients who develop a rash without an identified cause.
• Orthostatic Hypotension: Use with caution in patients with known cardiovascular or cerebrovascular disease. 
• Leukopenia, Neutropenia, and Agranulocytosis has been reported with antipsychotics. Patients with a pre-existing low white blood cell count (WBC) or a history of leukopenia/neutropenia should have their complete blood count (CBC) monitored frequently during the first few months of therapy and should discontinue Ziprasidone at the first sign of a decline in WBC in the absence of other causative factors.
• Seizures: Use cautiously in patients with a history of seizures or with conditions that lower seizure threshold.
• Potential for Cognitive and Motor impairment: Patients should use caution when operating machinery.
• Suicide: Closely supervise high-risk patients.