Generic
Risperidone
55 brands available in the market
At a glance
Risperidone is an atypical antipsychotic used for schizophrenia, mania, and irritability associated with autism. Its activity is mediated through a combination of dopamine (D2) and serotonin (5-HT2) receptor antagonism.
Description
Risperidone is a selective monoaminergic antagonist with high affinity for serotoninergic 5-HT2 and dopaminergic D2 receptors. It also binds to alpha1 adrenergic receptors and with lower affinity to H1 histamine and alpha2 adrenergic receptors. It has no affinity for cholinergic receptors.
Indications
- Acute and chronic psychoses
- Mania
- Schizophrenia
- Irritability associated with autism (5-16 years)
Therapeutic class
Atypical neuroleptic drugs
Pharmacological class
Benzisoxazole Derivative (Atypical Antipsychotic)
Pharmacology
Risperidone blocks serotonin 5-HT2 and dopamine D2 receptors. As a potent D2 antagonist, it improves positive symptoms of schizophrenia but causes less depression of motor activity. Balanced serotonin and dopamine antagonism may reduce extrapyramidal side effects and extend therapeutic activity to negative and affective symptoms.
Mechanism of action
Controls psychosis symptoms by blocking dopamine and serotonin receptors.
Dosage
Adult Dose (Oral):
- Psychoses: Day 1: 2 mg (1-2 divided doses); Day 2: 4 mg; maintenance: 4-6 mg/day; max 16 mg/day
- Schizophrenia: 1 mg twice daily initially; titrate to 3 mg twice daily target
- Mania: 2 mg/day initially; maintenance 1-6 mg/day
- Elderly/hepatic/renal impairment: 1 mg/day initially in 2 divided doses
- Tourette syndrome: 0.5-1 mg/day; up to 6 mg/day
- PTSD: 0.5-8 mg/day
Pediatric Dose (Oral):
- Schizophrenia (≥13 years): 0.5 mg/day; up to 3 mg/day; 1-6 mg/day
- Mania (≥10 years): 0.5 mg/day; up to 2.5 mg/day; 0.5-6 mg/day
- Autism irritability (5-16 years, >20 kg): 0.5 mg/day; up to 1 mg/day
Administration
- May be taken with or without food; take at a fixed time
- Oral disintegrating tablet: Do not handle with wet hands; place in mouth, do not swallow
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Side Effects:
- Dizziness
- Sleepiness
- Orthostatic hypotension
- Dry mouth
- Weight gain
- Constipation
- Muscle stiffness
- Restlessness
- Tremor
- Hyperprolactinemia
- Insomnia, anxiety, headache
Precautions & warnings
- May affect driving ability; do not drive if drowsy or dizzy
- Discontinue if Neuroleptic Malignant Syndrome (fever, muscle rigidity, altered consciousness) occurs
- Rise slowly to avoid orthostatic hypotension
- May cause weight gain, increased blood sugar and cholesterol; monitor regularly
- Do not stop abruptly
- Risk of suicidal thoughts or behavior; monitor
Contraindications
- Hypersensitivity to risperidone or any component
Drug interactions
- Levodopa and dopamine agonists: Antagonized effects
- Clozapine: Increased serum levels
- Carbamazepine: Increased serum levels (may also decrease risperidone levels)
- Indinavir, ritonavir: Increased risk of neuroleptic malignant syndrome
- Antihypertensives: Enhanced hypotensive effect
Food interactions
Alcohol with Risperidone may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe; risperidone and 9-hydroxyrisperidone are excreted in human breast milk; do not breastfeed.
Pediatric use
Pediatric dose based on age and condition; autism irritability for 5-16 years; psychoses not recommended in children under 15 years.
Geriatric use
Elderly patients require lower doses; 0.5 mg twice daily initially.
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment needed (0.5 mg twice daily initially); consult your doctor.
Hepatic Impairment: Caution in liver disease; dose adjustment needed (0.5 mg twice daily initially); consult your doctor.
Overdose effects
No overdose information available; consult your doctor if taken in excess.
Storage conditions
Do not store above 30°C; keep away from light; keep out of reach of children.
Chemical structure
Risperidone