II. Class

  1. Atypical Antipsychotic (Second Generation agent)
  2. Neuroleptic

III. Adverse Effects

  1. Insomnia
  2. Hypotension
  3. Weight gain
  4. Extrapyramidal Side Effects
    1. Low risk when daily dose under 10 mg
  5. Peristent Tardive Dyskinesia
    1. Lower Incidence than with other Neuroleptics
  6. Exacerbates Parkinson's Disease movement

IV. Dosing

  1. Initial
    1. Adult: 1 mg PO bid
    2. Elderly: 0.25 mg qd to 0.5 mg PO bid
  2. Slow titration to average dosing
    1. Adult: 2 to 4 mg PO daily (or divided bid)
    2. Elderly with Dementia: 0.5 to 0.75 mg PO bid
  3. Maximum: 16 mg/day

V. Monitoring

  1. See Antipsychotics
  2. Consider EKG, Electrolyte and Magnesium monitoring due to QT Interval prolongation risk

VI. Drug Interactions

  1. Metabolized by Cytochrome P450 2D6
  2. Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
    1. Clozapine
    2. Fluoxetine
    3. Paroxetine
  3. Decrease Antipsychotic levels (lower efficacy)
    1. Barbiturates
    2. Carbamazepine
    3. Phenytoin
    4. Rifampin
  4. Other effects
    1. Increased antihypertensive effect (may result in Hypotension)
    2. Raises Prolactin levels
    3. Avoid concurrent use of other medications prolonging QT Interval
      1. See Prolonged QT Interval due to Medication

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Related Studies

Cost: Medications

risperidone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
RISPERIDONE 0.25 MG TABLET Generic $0.04 each
RISPERIDONE 0.5 MG ODT Generic $0.79 each
RISPERIDONE 0.5 MG TABLET Generic $0.04 each
RISPERIDONE 1 MG ODT Generic $1.17 each
RISPERIDONE 1 MG TABLET Generic $0.04 each
RISPERIDONE 1 MG/ML SOLUTION Generic $0.27 per ml
RISPERIDONE 2 MG ODT Generic $0.90 each
RISPERIDONE 2 MG TABLET Generic $0.05 each
RISPERIDONE 3 MG ODT Generic $1.16 each
RISPERIDONE 3 MG TABLET Generic $0.07 each
RISPERIDONE 4 MG TABLET Generic $0.09 each
risperdal (on 1/19/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
RISPERDAL CONSTA 12.5 MG VIAL $268.14 each
RISPERDAL CONSTA 25 MG VIAL $535.80 each
RISPERDAL CONSTA 37.5 MG VIAL $803.27 each
RISPERDAL CONSTA 50 MG VIAL $1,072.26 each