Precautions and warnings

People with existing heart conditions should use this medication with caution. Stop taking it if you notice signs of involuntary movements (tardive dyskinesia). Extra care is needed for those with kidney or liver problems, older adults, people with epilepsy, Parkinson’s disease, or those who are pregnant. This medication may cause drowsiness and a drop in blood pressure when standing up. It should be stopped gradually, not suddenly. People with diabetes, or those at risk for diabetes, should have their blood sugar monitored regularly.

Drug Interactions

Risperidone can reduce the effects of levodopa and dopamine agonists. It may also raise the blood levels of clozapine and carbamazepine when used together. However, carbamazepine can lower the blood levels of risperidone. Combining risperidone with indinavir or ritonavir increases the risk of neuroleptic malignant syndrome, a serious condition.

Serious warning: Risperidone can make the blood pressure-lowering effects of some antihypertensive drugs stronger, which can be dangerous.

Contraindications

Risperidone should not be used by people who are allergic to it.

Mode of actions

Risperidone is a newer type of antipsychotic medicine. It works by blocking certain receptors in the brain, mainly dopamine (D2) and serotonin (5-HT2) receptors. It can also affect adrenergic (?1 and ?2) and histamine (H1) receptors. Compared to older antipsychotic drugs, risperidone is less likely to cause movement-related side effects.

Dosage & Administration

Adult: PO: Schizophrenia Initial: 2 mg/day, up to 4 mg/day on the 2nd day if needed. May further adjust doses at wkly intervals. Maintenance: 4-6 mg/day. Max: 16 mg/day.
Elderly: Initially, 0.5 mg bid gradually increased in increments of 0.5 mg bid. Maintenance: 1-2 mg bid.

Acute manic episodes of bipolar disorder Initial: 2-3 mg once daily. May increase slowly if needed. Max: 6 mg/day.

Psychoses: 2 mg in 1-2 divided doses on 1st day then 4 mg in 1-2 divided doses on second day (Slower titration appropriate in some patients); usual dose range 4-6 mg daily

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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