Can Geodon Negatively Affect Overall Cholestrol?
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Q:  Can Geodon Negatively Affect Overall Cholestrol?


My question is about whether or not Geodon can negatively affect overall cholesterol.  My cholesterol has always been below 200, ranging from 186-195 with the breakdown numbers always being excellent.   This year the round number  suddenly jumped 40 points to 224.  The other numbers  remained the same as in past years - very good.  I had begun taking  Geodon about  2-3 months before the test.  Could it be the cause of such a large spike?   

My eating had not been quite as healthy the past 6-9 months due to  extreme stress over other health issues, but not enough to  raise it that much I  would think.  I also started taking Vyvanse weight the same time as Geodon,  replacing the basic ritalin I had been  on.  Other than that, nothing else had  changed medication, weight or lifestyle-wise.  I'm particularly curious about  the Geodon  and possibly Vyvanse.  

Thanks for any insight or information  you can provide.

 

Dear Laura --
Generally ziprasidone (Geodon) is thought to be "weight neutral", and along with that goes a presumption that it is also neutral in terms of cholesterol and glucose levels.  However, formal studies of this are lacking. 

For example, the recent very large review Cochrane on this subject found that ziprasidone (Geodon) was less likely to cause weight gain than other "atypical antipsychotics", the other members of its drug class.  But the review does not state specifically that there was no weight gain with ziprasidone. 

Likewise, the review concludes “It was associated with less cholesterol increase than olanzapine, quetiapine and risperidone.”  Again, no specific statement that cholesterol does not increase; just less than the others. The problem is that in quite a few of these studies, there was not a parallel placebo group against which to compare directly.  Without that, it is hard to tell whether any weight gain or cholesterol increases that are observed might not just be the usual trend (particularly in the United States) of increases over time.

By comparison, another review concludes “ziprasidone has important advantages in that it is not associated with clinically significant weight gain or adverse changes in cholesterol…”Greenberg  But that appeared in a journal which I think might publish “ghost-written” papers that are actually written by company employees (the tone of this particular summary sure sounds like it), so I don’t think this is necessarily a trustworthy source.

In your case, the only way to really know is to stop ziprasidone and watch what happens to cholesterol.  Of course you wouldn't do that on your own, and stopping it quickly has its own potential risks.  So please do not consider that approach. 

You might be surprised at the size of the cholesterol increase a person can experience just from "stress".  So I don't think it's a slamdunk that ziprasidone did this.  Stimulants are generally not worrisome in terms of cholesterol levels, so I agree with you that the amphetamine (Vyvanse) is less likely to be the source of the problem.

Good luck getting that all figured out.

Dr. Phelps

 


Published November, 2009
 

 

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