Two medicines, side by side
Risperidone vs ziprasidone
Risperidone and ziprasidone are both labeled for bipolar disorder and schizophrenia. Drugs@FDA records approvals of risperidone since 1993 and of ziprasidone since 2001. Pharmacies paid $0.0368 per risperidone 0.25 mg tablet and $0.269 per ziprasidone HCl 20 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Risperidone, “The drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D 2 ) and serotonin Type 2 (5HT 2 ) receptor antagonism.”; Ziprasidone, “The mechanism of action of ziprasidone in the treatment of the listed indications could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 ) antagonism.”
Check it at the source: the risperidone FDA label on DailyMed (effective May 28, 2026); the ziprasidone FDA label on DailyMed (effective July 20, 2026).
Highlights of the risperidone record
Risperidone (Risperdal) · label of May 28, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. RISPERDAL is not approved for the treatment of patients with dementia-related psychosis. [see Warnings and Precautions (5.1) ] WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsRISPERDAL is an atypical antipsychotic indicated for: Treatment of schizophrenia ( 1.1 ) As monotherapy or adjunctive therapy with lithium or valproate, for the treatment of acute manic or mixed episodes associated with Bipolar I Disorder ( 1.2 ) Treatment of irritability associated with autistic disorder ( 1.3 ) 1.1 Schizophrenia RISPERDAL (risperidone) is indicated for the treatment of schizophrenia. […]
On the market
- Earliest approval on file
- December 29, 1993
- Generic labelers
- 37 labelers
- Pharmacy cost
- $0.0368 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Highlights of the ziprasidone record
Ziprasidone (Geodon) · label of July 20, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Ziprasidone capsules are not approved for the treatment of patients with dementia-related psychosis [see Warnings and Precautions ( 5.1 )]. WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsZiprasidone capsules are indicated for the treatment of schizophrenia, as monotherapy for the acute treatment of bipolar manic or mixed episodes, and as an adjunct to lithium or valproate for the maintenance treatment of bipolar disorder. […]
On the market
- Earliest approval on file
- February 5, 2001
- Generic labelers
- 23 labelers
- Pharmacy cost
- $0.269 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Source: FDA drug labels via openFDA (Risperidone label of May 28, 2026, Ziprasidone label of July 20, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do risperidone and ziprasidone differ on the record?
How each works, in its label's words: Risperidone, “The drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D 2 ) and serotonin Type 2 (5HT 2 ) receptor antagonism.”; Ziprasidone, “The mechanism of action of ziprasidone in the treatment of the listed indications could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 ) antagonism.”
Both are in FDA's class atypical antipsychotics.
Half-life, in each label's words: Risperidone, “The apparent half-life of risperidone was 3 hours (CV=30%) in extensive metabolizers and 20 hours (CV=40%) in poor …”; Ziprasidone, “Elimination of ziprasidone is mainly via hepatic metabolism with a mean terminal half-life of about 7 hours within the …”
Both labels carry a boxed warning; the records quote them.
Generics: risperidone since 2008; ziprasidone since 2012 (Drugs@FDA).
| Risperidone | Ziprasidone | |
|---|---|---|
| Labeled for | Bipolar disorder, Schizophrenia | Bipolar disorder, Schizophrenia |
| Pharmacologic class | Atypical Antipsychotic | Atypical Antipsychotic |
| How it works (label) | The mechanism of action of risperidone in schizophrenia is unclear. The drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D 2 ) and serotonin Type 2 (5HT 2 ) receptor antagonism. | The mechanism of action of ziprasidone in the treatment of the listed indications could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 ) antagonism. |
| Half-life (label) | The apparent half-life of risperidone was 3 hours (CV=30%) in extensive metabolizers and 20 hours (CV=40%) in poor metabolizers. | Elimination of ziprasidone is mainly via hepatic metabolism with a mean terminal half-life of about 7 hours within the proposed clinical dose range. |
| Earliest approval on file (Drugs@FDA) | December 29, 1993 | February 5, 2001 |
| First generic approved | June 30, 2008 | March 2, 2012 |
| Generic labelers (NDC) | 37 labelers | 23 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0368 per tablet (Risperidone 0.25 mg tablet) | $0.269 per capsule (Ziprasidone HCl 20 mg capsule) |
| 12-month price change | -13% | -13% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 131,095 | 6,148 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Ziprasidone label, drug interactionsRisk of serotonin syndrome with concomitant therapy with other serotonergic drugs such as SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines, and St. John’s Wort [see Contraindications ( 4.3 ), Warnings and Precautions ( 5.4 ), Adverse Reactions ( 6.2 )].
Source: FDA drug labels via openFDA
What next?
- Alternatives to risperidone
- every medicine labeled for the same conditions