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Risperidone

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Risperidone, Risperdal

  • Class
  1. Atypical Antipsychotic (Second Generation agent)
  2. Neuroleptic
  • 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
  • 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
  • Monitoring
  1. See Antipsychotics
  2. Consider EKG, electrolyte and Magnesium monitoring due to QT Interval prolongation risk
  • 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
  • References
  1. Jeste (2000) Am J Psychiatry 157:1150-5 [PubMed]
  2. Motsinger (2003) Am Fam Physician 67(11):2335-40 [PubMed]