What is Risperdal (Risperidone)?
Risperdal is an antipsychotics (neuroleptic) medication with risperidone as a main active component.
What is Risperdal (Risperidone) used for?
Risperdal is prescribed to treat:
- Acute and chronic schizophrenia. Psychotic states with a predominance of productive and negative symptoms.
- Affective disorders in case of various mental disorders.
- Behavioral disorders in dementia patients with aggressive symptoms (angry outbursts, physical violence), activity disorders (agitation, delirium) or psychotic symptoms.
- Behavioral disorders in teenagers from 15 years old and adults with reduced intelligence or mental retardation, in cases where destructive behavior (aggressiveness, impulsivity) is dominating.
- As a mood stabilizer (as adjunct therapy) in a treatment of mania in case of bipolar disorder.
Avoid taking Risperdal in case of:
- hypersensitivity to risperidone;
- until 15 years old.
Risperdal (Risperidone) dosage
Adults and children over 15 years old should take Risperdal pills by mouth 1 or 2 times a day.
Initial dosage is 2 mg of Risperidone a day. The second-day dosage is increased to 2 - 4 mg a day. From this point, Risperdal dosage can be either maintained the same or individually adjusted, if necessary, in a range of 4 - 6 mg a day.
Dosages above 10 mg a day did not show a higher efficiency compared to lower doses and may cause extrapyramidal symptoms. The maximum dosage is 16 mg a day.
Initial dosage for elder people and those, suffering from liver and kidney diseases is 0.5 mg 2 times a day. Risperidone dosage can be individually increased to 2.1 mg two times a day.
In case of behavioral disorders in patients with dementia, an initial dosage is 0.25 mg of Risperdal 2 times a day. Then the dosage is increased by 0.25 mg 2 times a day, no more than a day. Optimal dosage is 0.5 mg two times a day (some people should take 1 mg 2 times a day). Take the drug 1 time a day, when you reach your optimal dosage.
In case of bipolar disorder with mania, an initial dosage is 2 mg of Risperdal a day taken 1 time. Increase dosages (2 mg a day) not more than one day. The optimal dosage of Risperidone is 2.6 mg a day, in this case.
Behavioral disorders in patients with mental retardation or dominance of destructive trends in the clinical picture. Initial dosage for people weighing 50 kg or more is 0.5 mg of Risperdal 1 time a day. Increasing the dosage - 0.5 mg a day, no more frequently than every other day. The optimal dosage is 1 mg a day.
Initial dosage for people weighing less than 50 kg - 0.25 mg 1 time a day. Increasing the dosage - 0.25 mg a day, no more frequently than every other day. The optimal dosage is 0.5 mg a day.
It is recommended to decrease to times an initial dose and the subsequent increase in the dosage for elderly people and people with renal or hepatic insufficiency.
Risperidal (Risperidone) side effects
Nervous system: insomnia, agitation, anxiety, headache, drowsiness, fatigue, dizziness, decreased the ability to concentrate, blurred vision, extrapyramidal symptoms (tremor, rigidity, hypersalivation, bradykinesia, akathisia, acute dystonia ), mania or hypomania.
In people with schizophrenia - hypervolemia (due to either polydipsia or syndrome of inappropriate ADH secretion ), tardive dyskinesia (involuntary rhythmic movements), neuroleptic malignant syndrome (hyperthermia, muscle rigidity, instability of autonomous functions, impaired consciousness), seizures.
Digestive system: constipation, dyspepsia, nausea or vomiting, abdominal pain, dry mouth, hypo- or hypersalivation, anorexia.
Cardiovascular system: orthostatic hypotension, reflex tachycardia, or increased blood pressure, stroke (in elderly people with predisposing factors).
Hematopoiesis: neutropenia, thrombocytopenia.
Endocrine system: galactorrhea, gynecomastia, irregular menstruation, amenorrhea, increased or decreased weight gain, hyperglycemia or exacerbation of pre-existing diabetes mellitus.
Genitourinary system: priapism, erectile dysfunction, abnormal ejaculation, anorgasmia, urinary incontinence.
Allergic reactions: rhinitis, rash, angioedema, photosensitivity.
Skin: dry skin, hyperpigmentation, itching, seborrhea.
In case of schizophrenia, it is recommended to gradually cancel the previous therapy, if clinically justified, at the beginning of treatment with risperidone. If patients are transferred from care depot antipsychotic drugs, it is recommended to start Risperdal intake instead of the next scheduled injection.
The risk of developing mania or hypomania can be greatly reduced by using lower doses of risperidone or a gradual dosages increase.
In case of orthostatic hypotension, especially during the initial period of dosage adjustment, consider lowering Risperidone dosages. Dosage should be increased gradually for people with cardiovascular system disorders as well as dehydration, hypovolemia, or cerebrovascular disorders.
If you have signs and symptoms of tardive dyskinesia, consider abolishing all antipsychotic drugs; neuroleptic malignant syndrome - cancel all antipsychotic drugs, including risperidone.
In case of carbamazepine and other liver enzymes inducers cancellation, risperidone dosage should be reduced.
Patients should be advised to refrain from overeating, because of possible weight gain.
You should be cautious driving a car or be involved in potentially hazardous activities that require high concentration and speed of reaction while taking Risperdal.
Risperdal (Risperidone) during pregnancy and breastfeeding
Treatment with Risperdal during pregnancy is possible if the expected benefit for a mother outweighs the potential risk to a fetus.
Risperidone penetrates into breast milk. Consider canceling breastfeeding, if you need to take Risperdal.
Risperidone treatment reduces the effectiveness of levodopa and others. It is a dopamine agonist.
Phenothiazines, tricyclic antidepressants, and beta-blockers increase plasma concentration (not affect the concentration of the active antipsychotic fraction).
Taking risperidone with carbamazepine other liver enzymes inducers reduce the concentration of risperidone in blood.
Clozapine decreases the clearance of risperidone.
Ethanol, drugs that suppress the central nervous system interact with Risperdal, depressing CNS function.
Antihypertensive drugs increase the severity of blood pressure lowering in patients receiving risperidone.
Fluoxetine may increase the concentration of risperidone in blood.
The recommended initial dosage of Risperdal in case of schizophrenia is 0.5 mg 2 times a day. The dosage may be increased to 2.1 mg 2 times a day.
In case of schizophrenia, the recommended initial dosage for people with liver disorders is 0.5 mg 2 times a day. The dosage may be increased to 2.1 mg 2 times a day.
For elderly people
In case of schizophrenia people of advanced age should start taking 0.5 mg of Risperdal 2 times a day. The dosage may be increased to 2.1 mg 2 times a day.
Using Risperdal for children
There is no data on about the safety of risperidone for children under 15 years old.
Risperdal (Risperidone) reviews
This drug for chronic mental illness is taken for years. According to Risperdal reviews, the drug has shown high efficiency to treat a lot of mental disorders (teenage psychoses, behavioral disorders in children, schizophrenia). In general, reviews of risperidone are associated with its adverse reactions.
People note most common Risperdal side effects, which are frequent urination, increased appetite, water retention, headaches, drowsiness, fatigue, restlessness, inner agitation, blurred vision, decreased blood pressure, which is dependent on the dose, decreased sexual desire in men.
Tardive dyskinesia of a face and mouth muscles, which is expressed by chewing movements of lips and tongue, grimacing, almost never occur while taking this drug. According to most feedbacks, the drug is rather well tolerated.
The appearance of atypical antipsychotics (AP) opens up new potential opportunities for treatment of schizophrenia in adolescents. Potential benefits of this psychotropic medications are associated with:
• better tolerance compared to older versions of neuroleptics;
• long-term use may even improve cognitive functioning of children;
• higher indicators of social functioning and social reintegration, compared to conventional neuroleptics.
In December 2003, FDA approved Risperdal (risperidone), manufactured by «Johnson & Johnson» to be used both as a monotherapy or in combination with lithium drugs for short treatment courses in case of acute manic or mixed attacks in bipolar mental disorder. Risperdal was the second atypical antipsychotic approved by FDA for use in combination therapy of bipolar disorder (the first of this group, Zyprexa (olanzapine) was approved in July 2003).
The decision to approve Risperdal was based on the results of three clinical studies, which showed efficiency and safety of this drug. Two of this researches have analyzed the use of Risperdal as a monotherapy drug, and the third - in combination with lithium medications. During all studies, patients were treated with Risperdal in a dose of 1 to 6 mg per day. There was a significant improvement, assess by YMRS scale (Young Mania Rating Scale), which is used to determine the severity of manic symptoms.
According to two studies, in which Risperdal was prescribed as monotherapy, there was an increase in body weight of 7% at 3.9% of people. In case of combination therapy, the figure was 10.5%. The most common side effects of using Risperdal as monotherapy were an extrapyramidal disorder, somnolence, dyspepsia, nausea, blurred vision, and hypersalivation. Side effects of using Risperdal in combination therapy included drowsiness, dizziness, parkinsonism, hypersalivation, akathisia, abdominal pain and urinary incontinence.