I know my doc initially said he tries other things first for his patients due to the serious side-effects it can cause but began to push for it after a period of time when I had certain, serious reactions to all of the others. I still put it off for years in favor of continuing to try others for the reasons mentioned, after reading Geodon's literature. I have been taking it now for 7 years; it does cause the drowsiness in the evenings, which is when I take all of my dose but am refreshed by morning. I cannot take it during the day. My follow-up EKGs and other work-ups have been normal over the years with no other side-effects; it has worked beautifully for me in controlling my rapid cycling with dosage adjustments. Would not have known that I would have had a such a positive reaction as everyone's chemistry so different and know that not everyone reacts the same to it or to any of the others. Never know until tried unfortunately; sometimes with negative results and in this case turned out thankfully to be positive.