Geodon was weight neutral for me. Completely. I took 160 mg per day for about 5.5 years. Initially, it was sedating, but that eased over time and I even started having trouble sleeping. Also, at one point it stopped having sufficient antimanic strength for me (perhaps related), so a second antipsychotic had to be added, but I have bipolar type 1 and can lean in the manic direction. I've heard others say it was strong enough for them, though.

Three and a half years in to my Geodon treatment, it started giving me akathisia. It was nice I had at least that period without it. Since by that time I was on the second antipsychotic, my psychiatrist attempted to take me off Geodon. That started destabilizing me, showing that Geodon did have at least some efficacy for me. He changed his mind and put me back up to 160 mg.

My akathisia grew worse over time despite being on a beta blocker (propranolol). My psychiatrist added Cogentin, which helped, but gave me bad dry mouth and worse, severe constipation. That didn't fly. So we used my benzo Ativan to ease the akathisia. That helped, but it would wear off over night and I'd be suffering the next morning until the Ativan kicked in again. I just had to get off the Geodon. The akathisia was hurting my quality of life. So we started weaning me off again.

Geodon was the hardest medication to get off to date. Bad withdrawals! It took me months to get to 0 mg, but the akathisia thankfully disappeared. I did, however, have to have my Seroquel XR dose increased to battle mania. I was on 350 mg when taking 160 mg Geodon. Now off Geodon I'm on 550 mg, or usually 600 mg.

Besides decreasing my med cocktail and eliminating akathisia, going off Geodon seemed to lower my triglycerides. Coincidence? I don't think so. Going off didn't lower my cholesterol, though. I have gained about 12 lbs since going off Geodon and having my Seroquel XR dose raised (about one year ago).

People on Geodon should ideally have an occasional EKG. It can affect the heart in some people, though very few. I never had such a problem.

I don't recommend battling akathisia with a benzo. It's taking me a while to get off Ativan completely. We tried to get me to 0 mg (and use just as a prn), but I had withdrawals.

I lost 40 lbs on a low carb diet in a 6 month period on the combo of Lithium ER, Tegretol XR, Lamictal, and Geodon. All were weight friendly for me. [Yes, even Lithium.] I maintained all but 8 to 10 lbs of that loss for four and a half years, maintaining a normal BMI. I'm in my 40s.

Abilify, Navane, and Seroquel XR doses of 350 mg and below were weight neutral for me, too.

Regular Seroquel was never weight friendly for me, but wasn't as unfriendly as Zyprexa, Invega, Risperdal, and Perphanazine (Trilafon).