Comparative Pharmacology
Head-to-head clinical analysis: GEODON versus RISPERIDONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: GEODON versus RISPERIDONE.
GEODON vs RISPERIDONE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ziprasidone is an atypical antipsychotic with high affinity for dopamine D2 and serotonin 5-HT2A receptors; it also antagonizes 5-HT2C, 5-HT1D, alpha1-adrenergic, and histamine H1 receptors, and moderately inhibits serotonin and norepinephrine reuptake.
Risperidone is an atypical antipsychotic that antagonizes dopamine D2 receptors and serotonin 5-HT2A receptors. It also has moderate affinity for alpha1-adrenergic and H1-histaminergic receptors, and low affinity for muscarinic receptors.
20 mg orally twice daily with food; may titrate to 40-80 mg orally twice daily; maximum 80 mg orally twice daily. For acute treatment, IM 10-20 mg as needed up to 40 mg/day.
Initial 2 mg orally once daily, titrated to target dose of 4-6 mg orally once daily (or divided twice daily); maximum 16 mg/day. Alternatively, long-acting IM injection: 25 mg IM every 2 weeks.
None Documented
None Documented
Clinical Note
moderateRisperidone + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Risperidone is combined with Fluticasone propionate."
Clinical Note
moderateRisperidone + Methylphenidate
"The risk or severity of adverse effects can be increased when Risperidone is combined with Methylphenidate."
Clinical Note
moderateRisperidone + Quinagolide
"The therapeutic efficacy of Quinagolide can be decreased when used in combination with Risperidone."
Clinical Note
moderateTerminal elimination half-life is approximately 7 hours (range 5-10 hours) for oral ziprasidone; after intramuscular administration, half-life is about 2-5 hours. This short half-life may require twice-daily dosing for oral therapy.
Risperidone: 3 hours (CYP2D6 extensive metabolizers), 20 hours (poor metabolizers); active metabolite 9-hydroxyrisperidone: 21-30 hours; steady-state reached in 5-6 days
Primarily hepatic metabolism via aldehyde oxidase and CYP3A4. Approximately 20% excreted renally as unchanged drug, with the remainder as metabolites (mostly fecal).
Renal (70% as metabolites, 14% as parent drug) and fecal (14%)
Category C
Category A/B
Atypical Antipsychotic
Atypical Antipsychotic
Risperidone + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Risperidone."