Risperdal (Risperidone)

Risperdal Review

Risperdal is used for treating schizophrenia or bipolar mania. It may also be used for other conditions as determined by your doctor.

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Risperdal Drug Class and Mechanism

Risperidone is an antipsychotic medication that works by interfering with the communication among nerves in the brain. The nerves communicate with one another by producing and releasing chemicals called neurotransmitters. The neurotransmitters attach to receptors on other nearby nerves, and the attachment of the neurotransmitter causes changes in the cells that have the receptor on them. Risperidone blocks several of the receptors on nerves including dopamine type 2, serotonin type 2, and alpha 2 adrenergic receptors and this blocks communication among nerves. Risperidone is a relatively new antipsychotic medication that probably has fewer side effects than many of the older medications.

Risperdal Uses

Risperidone was approved by the United States Food and Drug Administration (FDA) in 1993 for the treatment of schizophrenia. On Wednesday, August 22, 2007, Risperdal was approved as the only drug agent available for treatment of schizophrenia in children ages 13–18; it was also approved that same day for treatment of bipolar disorder in youths ages 10–18, joining lithium. Risperidone contains the functional groups of benzisoxazole and piperidine as part of its molecular structure. In 2003 the FDA approved risperidone for the short-term treatment of the mixed and manic states associated with bipolar disorder. In 2006 the FDA approved risperidone for the treatment of irritability in children and adolescents with autism. Like other atypical antipsychotics, it has also been used off-label for the treatment of anxiety disorders, such as Obsessive-Compulsive disorder; severe, treatment-resistant depression with or without psychotic features; Tourette's disorder; disruptive behavior disorders in children; and eating disorders, among others. A multi-year UK study by the Alzheimer's Research Trust suggested that this and other neuroleptic anti-psychotic drugs commonly given to Alzheimer's patients with mild behavioural problems often make their condition worse. Risperidone usually is begun as two small doses each day. The doses often are increased every few days or each week until the optimal dose is found. Patients who are elderly or have kidney disease may need lower doses since the kidneys, which are partially responsible for removing risperidone from the blood, remove risperidone more slowly, and this can lead to toxic levels of risperidone in the blood. Similarly, patients with liver disease may need lower doses since the liver also is partially responsible for removing risperidone.

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Risperdal Side Effects

Common side effects include akathisia, anxiety, insomnia, low blood pressure, muscle stiffness, muscle pain, sedation, tremors, increased salivation, and stuffy nose. Risperidone has been associated with minimal to moderate weight gain, with one study finding that 26 to 38 percent of participants on the drug experienced weight gain. It has also been known to cause sexual dysfunction such as retrograde ejaculation. Occasionally breast tenderness and eventually lactation in both genders may occur. Many antipsychotics are known to increase prolactin because they inhibit dopamine. However, risperidone is known to increase prolactin to a greater extent than most other antipsychotics, such as quetiapine. It is thought that once risperidone raises prolactin, it may cause non-cancerous tumors in the pituitary gland. This may recur even if the patient has switched to a different antipsychotic. Risperidone can potentially cause tardive dyskinesia (TD), extrapyramidal symptoms (EPS), and neuroleptic malignant syndrome (NMS); although the risk of tardive dyskinesia is generally less than for the older typical antipsychotics[citation needed]. Also, risperidone can trigger diabetes and more serious conditions of glucose metabolism, including ketoacidosis and hyperosmolar coma.

Risperdal Pregnancy

There are no adequate studies of risperidone in pregnant women. Some studies in animals suggest no important effects on the fetus, whereas others suggest an ill-effect. Risperidone can be used in pregnancy if the physician feels that the benefits outweigh the potential but unknown risks.

Risperdal Overdose

Premarketing experience included eight reports of acute RISPERDAL® overdosage with estimated doses ranging from 20 to 300 mg and no fatalities. In general, reported signs and symptoms were those resulting from an exaggeration of the drug's known pharmacological effects, i.e., drowsiness and sedation, tachycardia and hypotension, and extrapyramidal symptoms. One case, involving an estimated overdose of 240 mg, was associated with hyponatremia, hypokalemia, prolonged QT, and widened QRS. Another case, involving an estimated overdose of 36 mg, was associated with a seizure. Postmarketing experience includes reports of acute RISPERDAL® overdosage, with estimated doses of up to 360 mg. In general, the most frequently reported signs and symptoms are those resulting from an exaggeration of the drug's known pharmacological effects, i.e., drowsiness, sedation, tachycardia, hypotension, and extrapyramidal symptoms. Other adverse reactions reported since market introduction related to RISPERDAL® overdose include prolonged QT intervaland convulsions. Torsade de pointes has been reported in association with combined overdose of RISPERDAL® and paroxetine.

Risperdal More Information

Risperdal is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor.