Geodon (Ziprasidone) for Hiccups: Not Recommended

Introduction to Ziprasidone

• The American College of Cardiology and other guideline societies do not recommend Geodon (ziprasidone) for treating hiccups, as there is no established evidence supporting its use for this indication, and it is not an FDA-approved use 1, 2

Established Uses of Ziprasidone

• The American Psychiatric Association recommends ziprasidone for acute agitation in schizophrenia, with a dose of 10-20 mg IM, and a maximum of 40 mg/day, with 20 mg showing more significant agitation reduction 2
• The American Psychiatric Association also recommends ziprasidone for emergency agitation, with a dose of 20 mg IM, and an onset of action within 15 minutes 1, 2
• The American Gastroenterological Association notes that ziprasidone has dopamine-blocking effects similar to phenothiazines used for nausea/vomiting in gastroparesis, and it can be used as an antiemetic for gastroparesis 1

Critical Safety Concerns

• The American Heart Association warns of a QTc prolongation risk associated with ziprasidone, and it is contraindicated in recent MI, baseline QT prolongation, or concurrent QT-prolonging medications 1

Alternative Treatments for Hiccups

• The American Academy of Family Physicians recommends chlorpromazine, metoclopramide, baclofen, and gabapentin as standard treatments for hiccups, with chlorpromazine being the only FDA-approved medication for this indication 3