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- What is risperidone, and how does it work (mechanism of action)?
- What brand names are available for risperidone?
- Is risperidone available as a generic drug?
- Do I need a prescription for risperidone?
- What are the side effects of risperidone?
- What is the dosage for risperidone?
- Which drugs or supplements interact with risperidone?
- Is risperidone safe to take if I'm pregnant or breastfeeding?
- What else should I know about risperidone?
What is risperidone, and how does it work (mechanism of action)?
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 because they cause a lesser degree of movement (extrapyramidal) 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.
Is risperidone available as a generic drug?
GENERIC AVAILABLE: Yes, risperidone. No, Risperdal Consta
What are the side effects of risperidone?
The most commonly-noted side effects associated with risperidone are:
- abdominal pain,
- fever, and
Another important side effect which may also occur include extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes) also occur. Risperidone may cause a condition called orthostatic hypotension during the early phase of treatment (the first week or two). Patients who develop orthostatic hypotension have a drop in their blood pressure when they rise from a lying position and may become dizzy or even lose consciousness.
Studies involving risperidone suggest an increased risk of hyperglycemia-related adverse reactions as seen in people with diabetes. Although there is no clear link between risperidone and diabetes, patients should be tested during treatment for elevated blood sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
What is the dosage for risperidone?
Risperidone can be administered once or twice daily. Initial oral dosing for treating schizophrenia 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 older than 13 years of age, 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 12.5 to 25 mg injected into the deltoid or gluteal muscle every two weeks. Dosage should not be adjusted more frequently than every 4 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.
Bipolar mania is treated with oral doses of 2-3 mg/day initially. Dose may be increased by 1 mg/day at every 24 hours up to a dose of 6 mg/day. The dose of Risperdal Consta for bipolar mania is 12.5 to 25 mg injected into the deltoid or gluteal muscle every two weeks. Dosage should not be adjusted more frequently than every 4 weeks.
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Which drugs or supplements interact with risperidone?
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 from 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 from risperidone.
Antifungal drugs such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral) when taken with risperidone also cause the metabolism (breakdown) of risperidone by the liver to be inhibited, which in turn causes elevated blood levels and may increase the risk of adverse reactions from risperidone.
Is risperidone safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of risperidone in pregnant women. Some unwanted effects have been reported in animal studies. Risperidone can be used in pregnancy if the physician feels that the benefits outweigh the potential but unknown risks.
Risperidone is excreted in human breast milk. Women receiving risperidone should not breastfeed.
What else should I know about risperidone?
What preparations of risperidone are available?
- Tablets: 0.25, 0.5, 1, 2, 3, and 4 mg.
- Oral solution: 1 mg/mL.
- Orally disintegrating tablets: 0.25, 0.5, 1, 2, 3, and 4 mg.
- Powder for injection: 12.5, 25, 37.5, and 50 mg.
How should I keep risperidone stored?
Tablets should be kept at room temperature, 15 C to 25 C (59 F to 77 F).
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Risperidone (Risperdal, Risperdal Consta, Risperdal M-TAB) is an atypical antipsychotic drug prescribed for treating bipolar mania, schizophrenia, stuttering, Tourette syndrome, autism in children and adolescents, and OCD (obsessive compulsive disorder). Side effects, drug interactions, warnings and precautions, and pregnancy safety should be reviewed prior to taking this medication.
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Related Disease Conditions
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.
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
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.
Obsessive Compulsive Disorder (OCD)
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.
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.
Autism Spectrum Disorder (in Children and Adults)
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.
Brief Psychotic Disorder
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 vs. Schizophrenia
Bipolar disorder and schizophrenia are mental illnesses that share some risk factors and treatments. Symptoms of bipolar disorder include mood changes and manic and depressive episodes. Symptoms of schizophrenia include unusual behavior, delusions, and hallucinations.
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is a condition that goes well beyond out-of-control dieting. With anorexia, the drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. There are psychological and behavioral symptoms as well as physical symptoms of anorexia including: depression, social withdrawal, fatigue, food obsession, heart and gastrointestinal complications, kidney function, flaky skin, brittle nails, and tooth loss (this list is not exhaustive).
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.
Schizotypal Personality Disorder
Schizotypal personality disorder is characterized by odd behaviors, feelings, perceptions, and ways of relating to others that interfere with one's ability to function. Medication and psychotherapy can help the sufferer to manage their symptoms.
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.
Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy 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.
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.
Bipolar Disorder in Children and Teens
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.
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