This sheet talks about exposure to ziprasidone in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is ziprasidone?

Ziprasidone is a medication used to treat bipolar disorder, schizophrenia, and schizoaffective disorder. Ziprasidone belongs to a group of medications called atypical or second-generation antipsychotics. A brand name is Geodon®. Ziprasidone can be taken orally (by mouth) or as an injection (shot).

I take ziprasidone. Can it make it harder for me to get pregnant?

A reported side effect of ziprasidone is female sexual dysfunction (problems with sexual desire, sexual arousal, orgasms, or sexual pain disorders). If a woman has this, it might make it harder for her to get pregnant.

I just found out that I am pregnant. Should I stop taking ziprasidone?

Talk with your healthcare providers before making any changes to this medication. For some women, the benefits of staying on an antipsychotic during pregnancy may outweigh any potential concerns. Only you and your providers know your medical history and can best determine whether or not you should stop taking ziprasidone during pregnancy.

Does taking ziprasidone increase the chance for miscarriage?

Miscarriage can occur in any pregnancy. It is not known if taking ziprasidone would increase this chance for miscarriage. There are no well controlled studies on ziprasidone use during pregnancy in humans. One prescription based study saw a slightly higher chance of a miscarriage among women who filled a prescription for ziprasidone in pregnancy.

Does taking ziprasidone increase the chance of having a baby with a birth defect?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. It is not known if taking ziprasidone would increase the chance for birth defects. There are no well controlled studies on ziprasidone use during pregnancy in humans. Animal studies have raised some concern about a higher chance for birth defects. However, animal studies cannot always predict how a medication would affect a human pregnancy. There are case reports of healthy outcomes in children born to mothers who used ziprasidone in pregnancy.

Could ziprasidone cause other pregnancy complications?

It is not known. There are no controlled studies on ziprasidone use during pregnancy in humans.

I need to take ziprasidone throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

It is unknown if taking ziprasidone could increase the chance of withdrawal symptoms in a newborn, sometimes called neonatal abstinence syndrome (NAS). However, since other similar medications have been associated with a chance for NAS, babies born to women taking ziprasidone near delivery can be monitored for symptoms such as stiff or floppy muscle tone, drowsiness, agitation, tremors, difficulty breathing, and problems with feeding. If a baby develops symptoms, in most cases they are expected to go away in a few days without long term health effects.

Will taking ziprasidone during pregnancy affect my baby’s behavior or cause learning problems?

There are no studies on behavior or development of infants exposed to ziprasidone during pregnancy. However, there are a few case reports of healthy children with normal development among women who used ziprasidone during pregnancy.

Can I breastfeed my baby if I am taking ziprasidone?

Ziprasidone has not been well studied for use while breastfeeding. There is one case report on a healthy well developing 6 month old baby whose mother took ziprasidone 40 mg and citalopram 60 mg daily throughout pregnancy and while breastfeeding. Talk to your healthcare providers about all of your breastfeeding questions.

What if the baby’s father takes ziprasidone?

There are no well-controlled studies in men exposed to ziprasidone. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for women who take psychiatric medications, such as ziprasidone. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.

Selected References

  • Damkier P, Videbech P. 2018. The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review. CNS Drugs. 32(4):351-366.
  • Einarson A, Boskovic R. 2009. Use and safety of antipsychotic drugs during pregnancy. J Psychiatr Pract. 15(3):183-92.
  • 2011. Drug Safety Communication: Antipsychotic drug labels updated on use during pregnancy and risk of abnormal muscle movements and withdrawal symptoms in newborns (issued 2/2011). https://www.fda.gov/Drugs/DrugSafety/ucm243903.htm
  • Haddad PM, Wieck A. 2004. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs; 64:2291-2314.
  • Huybrechts KF, et al. 2016. Antipsychotic use in pregnancy and the risk for congenital malformations. JAMA Psychiatr. 73(9):938-46.
  • Khan SJ, et al. 2016. Bipolar Disorder in Pregnancy and Postpartum: Principles of Management. Curr Psychiatry Rep; 18(2):13.
  • Kulkarni J, et al. 2015. Antipsychotic use in pregnancy. Expert Opin Pharmacother; 16(9):1335-45.
  • Ruzic K, et al. 2009. Pregnancy and atypical antipsychotics. Psychiatr Danub; 21(3):368-70.
  • Sørensen MJ, et al. 2015. Risk of Fetal Death after Treatment with Antipsychotic Medications during Pregnancy. PLoS One. 2015 Jul 10;10(7):e0132280.
  • Werremeyer A. 2009. Ziprasidone and citalopram use in pregnancy and lactation in a woman with psychotic depression. Am J Psychiatry; 166(11):1298.
  • Uguz F. 2016. Second-generation antipsychotics during the lactation period: A comparative systematic review on infant safety. J Clin Psychopharmacol.36:244-52.
  • Haddad PM, Wieck A: Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs 2004;64:2291-2314.