RISPERIDONE

Second generation antipsychotic medicine with dopamine D2, 5-HT2A, alpha1-adrenoceptor and histamine-1 receptor antagonistic activity

Dosage Forms

Tablet

2 mg

Uses

  • Schizophrenia
  • Moderate to severe manic episodes in bipolar disorder
  • Persistent aggression in patients with moderate to severe Alzheimer’s dementia
  • Conduct disorder in children above 5 years and adolescents

Dose and Duration

Schizophrenia

Adult and child over 12 years: 2 mg in 1–2 divided doses on day 1 increased on day 2 to 4 mg daily in 1–2 divided doses if required. Usual dose range 4–6 mg/day. Only use doses above 10 mg if potential benefit outweighs risk (max 16 mg/day)

Elderly: starting dose of 0.5 mg every 12 hours increased by increments of 1 mg/day to 1–2 mg every 12 hours

In renal and hepatic impairment: ½ adult dose, with slower titration

Manic episodes of bipolar disorder

Adult: 2 mg once daily increased at intervals of at least 24 hours in dose increments of 1 mg/day (max 6 mg/day)

Child 12–18 years: initially 0.5 mg once daily adjusted in steps of 0.5–1 mg daily according to response. Usual dose 2.5 mg daily in 1–2 divided doses (max 6 mg daily)

Elderly: same dose as for schizophrenia above

Persistent aggression in Alzheimer’s dementia

Adult: 0.25 mg every 12 hours individually increased at intervals of at least 48 hours by increments of 0.5 mg/day to a usual optimal dose of 0.5 mg every 12 hours (max 1 mg every 12 hours) for a max of 6 weeks

Conduct disorder (max 6 weeks)

Child 1–18 years ≥ 50 kg: initially, 0.5 mg once daily increased at intervals of at least 48 hours by 0.5 mg once daily if required. Optimum dose, 1 mg once daily. Dose range 0.5–1.5 mg once daily

Child 1–18 years ≤ 50 kg: initially 0.25 mg once daily increased by 0.25 mg at least after 48 hours, if required. Optimum dose 0.5 mg once daily. Usual dose range 0.25–0.75 mg once daily

Contra-indications

  • Hypersensitivity to risperidone

Side Effects

  • Hyperprolactinaemia
  • Weight gain, increased appetite, decreased appetite
  • Insomnia, sleep disorder, agitation and anxiety, depression, sedation, headache
  • Parkinsonism, extrapyramidal symptoms, tremor, tardive dyskinesia
  • Blurred vision, conjunctivitis
  • Tachycardia, hypertension
  • Pharyngolaryngeal pain, nose bleed, nasal congestion, dyspnoea, cough, respiratory tract infections
  • Gastrointestinal disturbances
  • Muscle spasms and pain, joint pain
  • Urinary incontinence
  • Oedema
  • General weakness, pyrexia
  • Rash, anaphylactic reaction
  • Neuroleptic malignant syndrome

Patient Instructions

  • Do not drive until you know how risperidone affects you

Pregnancy

  • Do not use

Breast-feeding

  • Can be used

⚠️ Caution

  • Risperidone is excreted in breast-milk. The advantage of breast feeding should be weighed against the potential risk to the child
  • Only use in pregnancy if potential benefit outweighs risk
  • Do not withdraw abruptly. Reduce doses gradually
  • Use with caution in patients with dementia with Lewy bodies, parkinsonism, prolactin-dependent tumours, dehydration, cataract surgery and in acute porphyria