Risperidone



Risperidone 821
Photo by: Tomasz Trojanowski

Definition

Risperidone is classified as an atypical antipsychotic drug. It is sold in the United States under the brand name of Risperdal.

Purpose

Risperidone is used for the management of symptoms of psychotic disorders such as schizophrenia .

Description

Risperidone is an atypical antipsychotic agent for two reasons. First, it is chemically unrelated to the older antipsychotic drugs. Second, unlike older antipsychotic drugs that primarily inhibit the actions of dopamine, a chemical in the brain , risperidone may also have some action against another brain chemical, serotonin. The proper level of both dopamine and serotonin are influential in maintaining mental well-being.

An advantage of using risperidone over one of the older antipsychotic drugs is a lower incidence of parkinsonian-like side effects. These side effects may be sufficiently troublesome to cause patients to discontinue treatment for their schizophrenia. For this reason, patients who have had negative experiences with older antipsychotics may benefit from risperidone. Also, some patients who showed little improvement with older antipsychotic drugs respond better to risperidone.

Risperidone is available in 0.25-mg, 0.5-mg, 1-mg, 2-mg, 3-mg, and 4-mg tablets and a solution containing 1 mg of drug in each milliliter of solution.

Recommended dosage

For treating psychotic disorders in adults, the usual starting dose of risperidone is 1 mg twice daily. Dosage is increased gradually until a target dose of 3 mg twice daily is reached. Some patients do just as well with a single daily dose (6 mg once a day, for example). There is little clinical evidence to indicate that increasing the daily dose beyond 8 mg offers additional benefit. However, higher doses may contribute to additional side effects. If the dose needs to be adjusted, the changes should made no more often than once per week.

In older patients (over age 60), starting dosage should not exceed 1 mg daily. Most patients should not take more than 3 mg daily. People with low blood pressure and those who have kidney disease should take a similarly reduced dose.

Precautions

Patients with a history of cardiovascular disease or low blood pressure should take risperidone only after discussing the risks and benefits with their physician, and then with close physician monitoring.

Risperidone has occasionally been associated with seizures . People with a past history of seizures should discuss with their doctor whether risperidone is the right antipsychotic for them to use.

People taking risperidone should avoid operating a motor vehicle or other dangerous machinery until they see how risperidone affects them. Some people have trouble regulating their body temperature while taking risperidone. Patients receiving this drug should be aware of this and avoid extremes in outdoor temperatures.

Side effects

The most common and bothersome side effect associated with risperidone is decreased blood pressure while standing up (known as orthostatic hypotension). This can cause dizziness or fainting. A decrease in blood pressure usually occurs early in therapy, while the proper dose is being established. It is more common in older patients than in younger ones. Usually, this side effect disappears entirely with time. If it continues, the physician may decrease the dose. Meanwhile, people taking risperidone should be aware of this side effect and get up slowly if they have been sitting for an extended time.

The most common nervous system side effects of risperidone include insomnia , agitation, anxiety, and headache. Early in therapy, patients may experience an inability to think clearly or perform certain tasks that require mental alertness. High doses of risperidone can cause unwanted sleepiness in about 40% of patients.

Antipsychotic drugs, including risperidone, can cause side effects that are similar to the symptoms of Parkinson's disease. The patient does not have Parkinson's disease, but may have shaking in muscles at rest, difficulty with voluntary movements, and poor muscle tone. These symptoms normally disappear if the drug is stopped.

The most common gastrointestinal side effects include nausea, vomiting, constipation, and difficulty digesting food.

Up to 10% of patients taking risperidone experience rhinitis (runny nose).

Interactions

There is very little information about how risperidone interacts with other drugs. However, because some patients receiving risperidone experience lowered blood pressure while standing, it is expected that other drugs that lower blood pressure may increase the incidence and severity of this side effect when taken with risperidone.

Resources

BOOKS

American Society of Health-System Pharmacists. AHFS Drug Information 2002. Bethesda: American Society of Health-System Pharmacists, 2002.

O'Brien, Charles P. "Drug Addiction and Drug Abuse." In Goodman & Gillman's The Pharmacological Basis of Therapeutics, edited by Joel G. Hardman, Ph.D. and Lee E. Limbird, Ph.D. Tenth Edition. New York: McGraw-Hill, 2001.

Jack Raber, Pharm.D.



User Contributions:

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Aug 15, 2010 @ 1:01 am
I started taking Rispiridone 2 days ago.
I was told it is used to Anxeity because I have a severe Anxiety disorder.
I'm not phsycotic or anything like that.
I'm just curious, is it for Axiety or not, because i don't want to be taking something that is not going to do the job i need done.
Thanks.
Holly.
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Dec 28, 2010 @ 10:22 pm
I just started taking risperdal. It seems to calm me. I hope it does better than other meds that I have taken in the past. Only time will tell :)
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Feb 16, 2011 @ 6:18 pm
i have been using rispiridone for a few years now but recently i have been wondering if i am taking the right medication, i have depression and i think i have anxiety, can rispiridone be used for depression and anxiety.
lisa
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Apr 26, 2012 @ 9:09 am
I started taking Risperidone 1mg 1 time a day 8 days ago. Since then I have been awake all night for 3 of those nights. The nights I do fall asleep, my body is tired but my brain is not. it takes me 3 to 4 hours to fall asleep after I took the med at bedtime. I wonder if there is something I can take to sleep. My Dr is very nice but I am a brand new patient (8 days ago ) and dont feel comfortable asking for meds.
However, my anxiety has decreased. I have been feeling very calm :)
Thanks, Lisa
Robyn
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May 8, 2012 @ 8:08 am
Hi Lisa. It might be a good idea to ask your Doctor if you could maybe try taking the Risperidone in the morning instead.It is not a good idea to take something else to help you fall asleep, your body is trying to get used to the medication and adding something else, even something natural, may complicate things. Also try to establish a calming bedtime routine: dim the lights if you can, have a bath, read a book... These will become signals to your body that it is time for sleep.
I hope that helps
Robyn
Douglas E. Hall
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May 31, 2012 @ 11:11 am
You do not differentitate between the dosage for risperdone to treat a manic episode so that the patient becomes well again and is stabilized and the dosage required once the patient is stabilized to prevent further mania in biipolar patients. These are two totally different treatment plans. Your dosage suggestions are for treating someone in a manic episode to get them stable again which can take up to 5 weeks. But once the person is stabilized then they can reduce the risperidone to a small dose of as low as .5 to 1 mg a day taken once a day or half the amount twice a day. Staying at the high dose you recommend once the manic episode has subsided and the person is stabilized will result in a low quality of life and adverse effects to the body. On the low dose if a person starts to get sick again then he should increase the dosage until stabilization returns. This correct medication maintenance therefore requires monitoring and a flexible doctor. Rigid doctors leads to an exit of patients from their practice.
G.(initial )
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Jul 23, 2014 @ 11:11 am
I am unable to take care of the sedation that is caused by risperdale,risperdale is nice yet it makes me too sedated during the day
to remain active to perform my daily activities.i was considering taking stimulants ,yet caffeine or other stimulants may aggravate the psychosis.
susan
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Oct 14, 2014 @ 8:08 am
My husband was put on 1mg Risperlet for paranoid schizofrinia. He is refusing to take it as he is convinced that taking it with his chronic medication (Carlox Glucofese Diablzade Natrix Zocor )that it would kill him. Is their any harm in taking it with the chronic medication? If so, is there any other pshycotic drug available that can be taken with his chronic medication?
shahbaz
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Oct 17, 2014 @ 4:04 am
1.Is timing of intercourse increased by using zaline or vepridone?
2.what are the positive effects of these two?
kindly reply on my email address.thanks

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