Risperdal (Risperidone) Medication Profile

Bipolar Medications Library

Risperdal - generic risperidone - is classed as an atypical antipsychotic. Federally-approved uses for Risperdal are:

• Schizophrenia
• Bipolar Manic/Mixed Episodes - short-term - alone or in combination with Lithium or Depakote (valproic acid)
• Irritability associated with Autistic Disorder in children and adolescents aged five to 16 years

Long-term efficacy of Risperdal in bipolar disorder has not been established in clinical trials.

Like other antipsychotic medications, Risperdal is required to carry a black box warning stating that it is not approved for use in elderly patients with dementia-related psychosis due to an increased risk of death. Clinical trials found that while Risperdal was less likely to be associated with patient mortality than Haldol (haloperidol), an older antipsychotic medication, more elderly patients in a group taking Risperdal died than did those in a group receiving placebo.

Major Warnings:

• Dosage should be reduced in patients with kidney or liver disease and in elderly patients.
• All antipsychotics carry a risk of causing Neuroleptic Malignant Syndrome (NMS). Be familiar with NMS symptoms and seek emergency help if they appear.
• All antipsychotics have the potential to cause tardive dyskinesia. Know the symptoms of tardive dyskinesia and seek emergency help if they appear.
• Patients with diabetes or risk factors for diabetes such as obesity and family history should have regular blood glucose monitoring.
• Patients taking Risperdal should be monitored for symptoms of hyperglycemia.
• Do not breast-feed while taking Risperdal, and notify your doctor if you are or plan to become pregnant.
• Combining Risperdal with blood pressure medicine can result in blood pressure that is too low.

Most Common Side Effects
In clinical trials, the most common side effects of Risperdal treatment (reported by 12 to 28 percent of patients) were:

• Extrapyramidal side effects
• Drowsiness/sleepiness
• Insomnia
• Agitation
• Dizziness
• Headache
• Anxiety
• Upset stomach/nausea
• Weight gain

In children with autistic disorder, the most common side effects were different:

• 67 percent of study participants reported sleepiness
• 47 percent of participants experienced increased appetite
• 42 percent reported fatigue
• 35 percent reported upper respiratory tract infection
• 22 percent reported increased saliva
• 21 percent reported constipation

Interactions

• Risperdal dosage may have to be increased when taken with Tegretol (carbamazepine)
• Dosage may have to be adjusted when Risperdal is taken with Paxil (paroxetine) or Prozac (fluoxetine)

See also: Risperdal Side Effects

Disclaimer: This is not intended to be all-inclusive or to replace information provided by your doctor or with the prescription from the manufacturer.

Nasrallah, H.A., White, T., and Nasrallah, A.T. Lower Mortality in Geriatric Patients Receiving Risperidone and Olanzapine Versus Haloperidol: Preliminary Analysis of Retrospective Data. Am J Geriatr Psychiatry, Aug 2004; 12: 437 - 439.

MedWatch. 2003 Safety Alert - RISPERDAL (risperidone).

US Food and Drug Administration. Risperdal Approved Label October, 2006.