Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Risperidone is an atypical antipsychotic
drug that is used for treating schizophrenia,
bipolar mania and autism. Other
atypical antipsychotic drugs include Olanzapine (Zyprexa), Quetiapine
(Seroquel), Ziprasidone (Geodon), Aripiprazole (Abilify) and
paliperidone (Invega).
Atypical antipsychotics differ from typical antipsychotics due to the lesser
degree of extrapyramidal (movement) side effects and constipation. Risperdal
Consta is an injectable, long-acting form of risperidone.
The exact
mechanism of action of risperidone is not known, but, like other
anti-psychotics, it is believed that risperidone affects the way the brain works
by interfering with communication among the brain's nerves. Nerves communicate
with each other by making and releasing chemicals called neurotransmitters. The
neurotransmitters travel to other nearby nerves where they attach to receptors
on the nerves. The attachment of the neurotransmitters either stimulates or
inhibits the function of the nearby nerves. Risperidone blocks several of the
receptors on nerves including dopamine type 2, serotonin type 2, and alpha 2
adrenergic receptors. It is believed that many psychotic illnesses are caused by
abnormal communication among nerves in the brain and that by altering
communication through neurotransmitters, risperidone can alter the psychotic
state. Risperidone was approved by the FDA in December, 1993.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes,
Risperdal. No, Risperdal Consta
PREPARATIONS: Tablets: 0.25,
0.5, 1, 2, 3, and 4 mg. Oral solution: 1 mg/mL. Orally disintegrating tablets: 0.5, 1, 2, 3, and
4 mg. Powder for injection: 12.5, 25, 37.5, and 50 mg.
STORAGE: Tablets should be kept at room temperature, 15-25 C (59-77 F).
PRESCRIBED FOR: Risperidone is used to treat schizophrenia, bipolar
mania [as a sole therapy or combination therapy with
lithium (Eskalith, Lithobid) or
valproate (Depakene, Depacon) and
for the treatment of irritability associated with autistic disorder in children
and adolescents. Clinical studies involving small numbers of patients have shown
some benefit in using risperidone for stuttering and
Tourette syndrome (non
FDA-approved uses). Another non-FDA approved use of risperidone is for
obsessive-compulsive disorders.
DOSING: Risperidone can be
administered once or twice daily. Initial dosing is generally 2 mg/day. Dose
increases can occur in increments of 1-2 mg/day, as tolerated, to a recommended
dose of 4-8 mg/day. In children, risperidone should be initiated at 0.5 mg once
daily, and can be increased in increments of 0.5 or 1 mg/day, as tolerated, to
a recommended dose of 2.5 mg/day. Risperidone can be given with or without
meals. The recommended dose of Risperdal Consta is 25 mg injected into
the deltoid or gluteal muscle every two weeks. Patients who have never received risperidone
are started on oral risperidone in order to evaluate tolerability. Patients then may be
transitioned to Risperdal Consta if oral risperidone is tolerated
DRUG INTERACTIONS: Risperidone may interfere with elimination by the
kidneys of clozapine (Clozaril), a different type of antipsychotic medication,
causing increased levels of clozapine in the blood. This could increase the risk
of side effects with clozapine.
Serotonin reuptake inhibitors such as paroxetine (Paxil), Sertraline
(Zoloft), and fluoxetine (Prozac) when taken with risperidone causes the
metabolism (breakdown) of risperidone by the liver to be inhibited, which in
turn causes elevated blood levels of risperidone, and may increase the risk of
adverse reactions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Tourette syndrome is disorder, which symptoms include involuntary facial tics, motor tics, and vocal tics. The cause of Tourette syndrome is not known. ADHD is associated with Tourette syndrome. Treatment includes medication, psychotherapy, and in severe cases surgery.
Autism in children and adults is a developmental disorder, characterized by impaired development in communication, social interaction, and behavior. Autism is classified as a pervasive developmental disorder (PDD), which is part of a broad spectrum of developmental disorders affecting young children and adults. There are numerous theories and studies about the cause of autism. The treatment model for autism is an educational program that is suitable to an individual's developmental level of performance. There is no "cure" for autism.
Psychotic disorders are a group of serious illnesses that affect the mind. Different types of psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, shared psychotic disorder, delusional disorder, substance-induced psychotic disorder, paraphrenia, and psychotic disorders due to medical conditions.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Stuttering is a speech disorder characterized by speech disruptions such as prolongations of speech sounds, syllables or words, frequent repetitions, or the inability to start a word. Over 3 million Americans stutter, and boys are more likely to stutter than girls. Stuttering may be developmental, neurogenic, psychogenic, or even genetically determined. Treatment for stuttering may incorporate stuttering therapy with a speech-language pathologist and educating the parents about restructuring the child's speaking environment.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Symptoms of a psychotic disorder vary from person to person and may change over time. The major
symptoms are hallucinations and delusions.
Hallucinations are unusual sensory experiences or perceptions of things that
aren't actually present, such as seeing things that aren't there, hearing
voices, smelling odors, having a "funny" taste in your mouth, and feeling
sensations on your skin even though nothing is touching your body.
Delusions are false beliefs that are persistent and organized, and that do
not go away after receiving logical or accurate information. For example, a
person who is certain his or her food is poisoned, even if it has been proven
that the food is fine, is suffering from a delusion.
Other possible symptoms of psychotic illnesses include:
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