What it's for (Indications)
- Risperidone is used for the treatment of acute and chronic schizophrenia, other psychosis, affective symptoms of schizophrenia, and bipolar disorders.
- The therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D2) and serotonin Type 2 (5HT2) receptor antagonism.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | For oral administration, take the medication via the mouth with a full glass of water, and with food. Follow the prescribed course of therapy given by the doctor or pharmacist. If a dose is missed, take it as soon as you remember on the same day; however, if the next day has arrived, take only that day's dose and do not double it. The medicine course should be completed as recommended by the doctor/pharmacist, even if symptoms subside. Do not stop treatment abruptly. For risperidone extended-release injectable suspension, it is recommended to establish tolerability with oral risperidone prior to initiating treatment. The injectable suspension should be administered every 2 weeks by deep intramuscular (IM) deltoid or gluteal injection by a healthcare professional, using the appropriate enclosed safety needle. For deltoid administration, use the 1-inch needle alternating injections between the two arms. For gluteal administration, use the 2-inch needle alternating injections between the two buttocks. Do not administer intravenously. This is a prescription medication. |
Safety & Warnings
Common Side Effects
- Common side effects include drowsiness, dizziness, lightheadedness, drooling, nausea, weight gain, fatigue, headache, insomnia, anxiety, agitation, impaired concentration, gastrointestinal disturbance, rhinitis, rash, blurred vision, depression, somnolence, respiratory tract infection (RTI), ear infection, cough, nasal congestion, pharyngolaryngeal pain, GI upset, dry mouth, toothache, asthenia (muscle weakness), muscle spasm, musculoskeletal pain, pain in extremities, pyrexia (fever), and edema.
- More serious adverse effects include orthostatic hypotension (decrease in blood pressure on standing up suddenly), reflex tachycardia, extrapyramidal symptoms (symptoms of Parkinson's disease), galactorrhea (spontaneous milk flow), menstrual disturbance, sexual dysfunction, priapism (prolonged erection), urinary incontinence, urinary tract infection (UTI), blood pressure changes, tachycardia, AV block (heart conduction problems), amenorrhea (absence of periods), gynaecomastia (male breast enlargement), skin reactions, altered LFTs, hyperglycemia (increased blood sugar), hyperprolactinemia (increased prolactin), anemia, conjunctivitis, chest pain, and flu-like illness.
- Rarely, neuroleptic malignant syndrome (NMS), water intoxication with hyponatremia (decreased sodium in blood), seizures, tardive dyskinesia (stiff, jerky movements), and intraoperative floppy iris syndrome may occur.
- Other potential side effects include cerebrovascular adverse events (including stroke), leukopenia/neutropenia and agranulocytosis, falls, potential for cognitive and motor impairment, and dysphagia.
Serious Warnings
- Black Box Warning: WARNING: 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. Risperidone for extended-release injectable suspension is not approved for the treatment of patients with dementia-related psychosis.
- Patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death and cerebrovascular adverse events, including stroke.
- Risperidone is not approved for the treatment of dementia-related psychosis.
- Monitor for Neuroleptic Malignant Syndrome (NMS), Tardive Dyskinesia (withdraw medication if signs occur), and metabolic changes including hyperglycemia and weight gain.
- Monitor for hyperprolactinemia.
- Orthostatic hypotension and falls are potential risks, especially in the elderly; patients should change position slowly from sitting or lying to standing.
- Leukopenia, neutropenia, and agranulocytosis have been reported; monitor complete blood counts in patients with pre-existing low WBC counts or drug-induced leukopenia/neutropenia.
- Caution is advised in patients with kidney, liver, or heart disease, epilepsy (monitor for seizures), parkinsonism, dementia, diabetes, bradycardia, hypokalemia, hypomagnesemia, or a family history of QT prolongation (problems with ECG).
- Risperidone may cause cognitive and motor impairment, so avoid driving or operating machinery until effects are known.
- Risperidone may make you sweat less, increasing the risk of heat stroke; avoid strenuous activity or exercise in hot weather, and avoid hot tubs.
- Inform your doctor of all medicines, including over-the-counter drugs, vitamins, herbal supplements, alcohol, marijuana, and prescription medicines like metoclopramide, opioid pain or cough relievers, drugs for sleep or anxiety (e.
- g.
- , alprazolam, lorazepam, zolpidem), muscle relaxants (e.
- g.
- , carisoprodol, cyclobenzaprine), or antihistamines (e.
- g.
- , cetirizine, diphenhydramine), as they can interact with risperidone.
- Use in pregnant females can be unsafe; consult a doctor.
- Not recommended for use in children; monitor children for extrapyramidal symptoms and other movement disorders, endocrinological status, and sedative effects.
- Do not stop using risperidone without consulting a doctor/pharmacist, as it can produce withdrawal symptoms.
- The medicine course should be completed as recommended by the doctor/pharmacist, even if symptoms subside.
- Store the medicine at room temperature, away from heat or direct sunlight.
How it Works (Mechanism of Action)
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 (D2) and serotonin Type 2 (5HT2) receptor antagonism. The clinical effect from risperidone results from the combined concentrations of risperidone and its major active metabolite, 9-hydroxyrisperidone (paliperidone). Antagonism at receptors other than D2 and 5HT2 may explain some of the other effects of risperidone.