Risperidone (Risperdal®): Basic Information - Simple and Practical Mental Health

Risperidone (US brand name Risperdal® and generic) is a second-generation (“atypical”) antipsychotic. Here is basic information about this medication.

FDA-approved indications

1. Treatment of schizophrenia

2. As monotherapy or adjunctive therapy with lithium or valproate, for the treatment of acute manic or mixed episodes associated with bipolar I disorder

3. Treatment of irritability associated with autistic disorder

Mechanism of Action/ Pharmacodynamics

Most importantly, risperidone is an antagonist at dopamine D2 and serotonin type 2 (5-HT2) receptors.

The binding affinities of risperidone for receptors of interest are as follows:

High affinity

– Serotonin 5-HT2

– Dopamine D2

– Alpha-1 and alpha-2 adrenergic

– H1 histaminergic

Low to moderate affinity

– Serotonin 5-HT1C

– Serotonin 5-HT1D

– Serotonin 5-HT1A

Weak affinity

– Dopamine D1

No affinity

– Cholinergic muscarinic

– Beta-1/ beta-2 adrenergic

Pharmacokinetics

Contraindications

Warnings and Precautions

Potential side effects

Please see THIS PAGE for a handout listing both the common and less common side effects of this medication along with the percentages of patients who report them.

Dosage

Recommended daily dosage:

Schizophrenia (adults)
Initial dose: 2 mg
Target dose: 4–8 mg
Effective dose range: 4–16 mg

Schizophrenia (adolescents)
Initial dose: 0.5 mg
Target dose: 3 mg
Effective dose range: 1–6 mg

Bipolar mania (adults)
Initial dose: 2–3 mg
Target dose: 1–6 mg
Effective dose range: 1–6 mg

Bipolar mania (children and adolescents)
Initial dose: 0.5 mg
Target dose: 1–2.5 mg
Effective dose range: 1–6 mg

Irritability associated with autistic disorder (weight <20 kg)
Initial dose: 0.25 mg
Target dose: 0.5 mg
Effective dose range: 0.5–3 mg

Irritability associated with autistic disorder (weight ≥20 kg)
Initial dose: 0.5 mg
Target dose: 1 mg
Effective dose range: 0.5–3 mg

Dosage forms and strengths

Tablets (Risperdal® and generic): 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg

Oral solution (Risperdal® and generic): 1 mg/mL

Orally disintegrating tablets (Risperdal M-tab® and generic): 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg

Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.

Risperidone long-acting injection (Risperdal Consta®)

News: July 6, 2016. Make sure you are discussing increased risk of gynecomastia with risperidone (Free)

Second-Generation Antipsychotics: Dose Equivalents

What should I be doing to monitor patients who are on an antipsychotic?

Second-generation (“Atypical”) antipsychotics

References

Risperidone Prescribing Information

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