Ziprasidone
Antipsychotic (atypical)
Brand names: Geodon
Oral health effects
Xerostomia (dry mouth)
Reduced salivary flow raising caries, candidiasis, and mucosal discomfort risk.
Clinical management: Hydration, sugar-free gum/xylitol, salivary substitutes, high-fluoride products; reinforce caries prevention.
QT prolongation caution
Notable QT-prolonging potential.
Clinical management: Review QT-prolonging drug interactions (e.g., some antiemetics, macrolides).
Dizziness on standing (orthostatic hypotension)
Orthostatic hypotension is a label warning; postural hypotension is listed as a frequent adverse reaction.
Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients.
Tardive dyskinesia (orofacial movements, lower risk)
Long-term use can cause potentially irreversible involuntary movements of the tongue, lips and jaw (label warning). The risk is lower than with older antipsychotics but not zero.
Clinical management: Look for involuntary tongue, lip or jaw movements; they can make instrumentation, impressions and denture retention difficult. Use short appointments, bite blocks and good support, and report new or worsening movements to the prescriber, as early detection matters.
Sources
- A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
- Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
- Ziprasidone prescribing information (FDA label) Macleods Pharmaceuticals Limited / DailyMed, 2023.
- Tardive dyskinesia risk with first- and second-generation antipsychotics in comparative randomized controlled trials: a meta-analysis. Carbon M, Kane JM, Leucht S, Correll CU. World psychiatry : official journal of the World Psychiatric Association (WPA), 2018.
- A review and guide to drug-associated oral adverse effects-Dental, salivary and neurosensory reactions. Part 1. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.