Monotherapy in adults and children/adolescents (10–17yrs old) for short-term treatment of acute manic or mixed episodes associated with bipolar I disorder, or in combination with lithium or valproate in adults.
Benzisoxazole; Antipsychotic
Risperidone is a selective monoaminergic antagonist having a high affinity for serotoninergic 5-HT2 and dopaminergic D2 receptors. Risperidone binds also to alpha1 adrenergic receptors and with lower affinity, to H1 histamine and alpha2 adrenergic receptors. Risperidone has no affinity for 8 cholinergic receptors. Risperidone, as a potent D2 antagonist, improves the positive symptoms of schizophrenia but causes less depression of motor activity. Balanced central serotonin and dopamine antagonism may reduce extrapyramidal side effect liability and extend the therapeutic activity to the negative and affective symptoms of schizophrenia.
ORAL Schizophrenia: Adult: Initially, 2 mg daily, may increase to 4 mg daily on the 2nd day, adjusted further in increments or decrements of 1-2 mg daily at wkly intervals. Doses may be given in 1-2 divided doses. Maintenance: 4-6 mg daily. Max: 16 mglday. 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: Adult: Initially, 2-3 mg once daily. May increase by 1 mg daily at intervals of at least 24 hr. Max: 6 mg daily. Elderly: Initiate w/ lower doses. INTRAMUSCULAR Schizophrenia: Adult: Give oral risperidone for a few days to assess tolerability prior to initiating inj. For patients not stabilised on oral risperidone: 25 mg every 2 wk. Patients stabilised on oral risperidone for at least 2 wk in doses 4 mg daily: 25 mg every 2 wk. Patients stabilised on oral risperidone for at least 2 wk in doses >4 mg daily: 37.5 mg every 2 wk. Continue oral risperidone for the 1st 3wk after the 1st inj. Elderly: Max dose: 25 mg every 2 wk.
Risperidone May antagonize the effects of levodopa and dopamine agonists. Chronic administration with Carbamazepine reduces plasma clearance of Risperidone. Chronic administration with Clozapine may decrease the clearance of Risperidone. Risperidone may enhance the effects of certain antihypertensives.
Preexisting CV diseases; discontinue use if signs & symptoms of tardive dyskinesia occur; renal & hepatic impairment, elderly, epilepsy; parkinsonism; pregnancy. May cause drowsiness & orthostatic hypotension. Gradual withdrawal is recommended. Monitor blood glucose in diabetics & patients at risk of developing diabetes.
Agitation, anxiety, dizziness, headache, somnolence; orthostatic hypotension; constipation, dyspepsia, nausea, vomiting, abdominal pain, blurred vision, erectile dysfunction, priapism, rhinitis, rash & allergy, galactorrhoea, gynaecomastia. menstrual disorders, extrapyramidal symptoms (rarely). wt gain, oedema, tardive dyskinesia. Neuroleptic malignant syndrome may occur rarely; seizures. May cause increased mortality in elderly w/ dementia-related psychosis.
Risperidone safety in pregnancy. A case report. The use of risperidone and other antipsychotic drugs during pregnancy is sometimes essential, although it is impossible to design clinical trials to demonstrate the safety of these kinds of drugs. Although no data are available for the use of paliperidone during breastfeeding, it is the active metabolite of risperidone. Risperidone data indicate that the concentrations of paliperidone (9-hydroxyrisperidone) in breast milk are low, and amounts ingested by the infant are small.
Treatment should consist of general measures employed in the management of overdosage with any drug. Consider the possibility of multiple drug overdosage. Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. Use supportive and symptomatic measures. There is no specific antidote to Risperidone.
Do not store above 30°C. Keep away from light and out of the reach of children.
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