Does risperidone make you sleepy
Risperidone – an antipyschotic medicine used to help symptoms of mental health conditions
1. About risperidone
Risperidone is medicine that helps with symptoms of some mental health conditions such as:
- schizophrenia (where you may see, hear or feel things that are not there or you believe things that are not true or you feel unusually suspicious or have muddled thoughts)
- mania symptoms of bipolar disorder, where your mood changes between feeling highly excited (mania) and very low (depression)
- aggressive or agitated behaviour in children (over 5 years) or young people with learning disabilities
- aggressive or agitated behaviour in adults with Alzheimer's disease
It's an antipsychotic medicine. It does not cure your condition but it can help the symptoms.
Risperidone is only available on prescription.
It comes as tablets (including tablets that dissolve in your mouth) and a liquid that you drink.
It can also be given as an injection (for schizophrenia only).
2. Key facts
- Risperidone works by affecting chemical messengers in the brain (neurotransmitters) like dopamine. It does not cure your condition but it helps to keep your symptoms under control.
- Risperidone does not work straight away. It can take several days or even months for some symptoms to get better.
- Common side effects include feeling sleepy, problems with your movement and headaches.
- It can make you feel more hungry than usual, so you may put on weight.
- It's best not to drink alcohol for the first few days of treatment until you see how the medicine affects you.
3. Who can and cannot take risperidone
Risperidone can be taken by most adults and children aged 5 years old and older.
Risperidone is not suitable for some people. Tell your doctor before starting the medicine if you:
- have ever had an allergic reaction to risperidone or any other medicine
- have a heart problem (including arrhythmia)
- have low blood pressure (hypotension)
- have had a stroke or are at high risk of having a stroke
- have ever had problems controlling the movements of your tongue, mouth and face
- have ever had a rare condition called neuroleptic malignant syndrome (symptoms include a high temperature, muscle stiffness, sweating, anxiety and excess saliva)
- have Parkinson's disease or dementia
- have ever had low levels of white blood cells
- have diabetes or epilepsy
- have ever had a prolonged or painful erection that lasted more than 2 hours
- have problems controlling your body temperature or overheating
- have kidney or liver problems
- have had a blood clot or someone in your family has had blood clots
4.
How and when to take risperidone It's important to take risperidone as your doctor tells you.
Dosage and strength
How much you take will depend on what you're taking it for. Your doctor may change your dose depending on how well risperidone works for you.
If you have problems with your kidneys or liver your doctor may ask you to take a lower dose and increase your dose very slowly.
Standard tablets come as 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg and 6mg strength tablets.
Tablets that dissolve in your mouth (dispersible) come as 1mg, 2mg, 3mg and 4mg strength tablets.
Dose for schizophrenia (under 65 years of age)
You'll usually start on a low dose of 2mg. Your doctor may increase this to 4mg a day on the second day. Most people feel better with daily doses of 4mg to 6mg.
You can take it as a single dose each day or you could take half your dose in the morning and half in the evening.
Dose for schizophrenia (over 65 years of age)
You'll usually start on a low dose of 0.5mg, taken twice a day. Your doctor may increase your dose to 1mg or 2mg, taken twice a day.
Dose for mania (under 65 years of age)
You'll usually start on a low dose of 2mg once a day. Your doctor may change your dose depending on how well risperidone works for you. Most people feel better with doses of 1mg to 6mg, taken once a day.
Dose for mania (over 65 years of age)
You'll usually start on a low dose of 0.5mg, taken twice a day. Your doctor may change your dose slowly to 1mg or 2mg, taken twice a day. This depends on how well risperidone works for you.
Dose for aggressive behaviour (18 years and older)
You'll usually start on a low dose of 0.
25mg, taken twice a day. Your doctor may increase your dose slowly to see how well risperidone works for you. Most people feel better with 0.5mg, taken twice a day. Some people may need 1mg twice a day. You may only be given risperidone for a few weeks.
Dose for aggressive behaviour in children (5 to 17 years)
Your child's dose will depend on their weight. It will usually start low and may be increased by a small amount every other day.
Your doctor will tell you how to increase the dose, depending on how well risperidone is working. Your child may only take it for a few weeks.
How to take it
Always follow the instructions in the leaflet that came with your medicine.
You can take this medicine with or without food.
How to take standard tablets
Swallow your tablet with a drink of water.
If you need to take half a tablet for your dose or if you have difficulty swallowing the whole tablet, use the score line on the tablet to break it in half.
How to take tablets that dissolve in your mouth (dispersible)
Make sure your hands are dry. Open the blister pack, remove a tablet and put it on your tongue. The tablet will begin dissolving within seconds.
You can have a drink of water afterwards if you like.
How to take liquid
Your medicine will come with a syringe or dropper (pipette) to help you to measure out the right dose.
Having risperidone injections
Some people with schizophrenia may need to have risperidone as an injection.
You will have an injection every 2 weeks at your GP surgery (or some people will have it while in hospital).
The dose will depend on how well risperidone works for you.
What if I forget to take it?
If you miss a dose and usually take risperidone:
- once a day – take the missed dose as soon as you remember unless it's less than 12 hours before the next dose is due. In this case leave out the missed dose and take your next dose as usual
- twice a day – take the missed dose as soon as you remember unless it's less than 8 hours before the next dose is due. In this case leave out the missed dose and take your next dose as usual
Do not take 2 doses at the same time to make up for a forgotten dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
Contact your doctor if you miss 2 doses or more.
They will tell you what you need to do about taking your risperidone.
What if I take too much?
Taking too much risperidone can cause serious side effects such as:
- feeling sleepy or tired
- unusual body movements
- problems standing and walking
- feeling dizzy
- a fast heartbeat
- a seizure or fit
Urgent advice: Contact 111 for advice now if:
- you take more than your usual dose of risperidone, even if you do not have any side effects
Call 111 or go to 111.nhs.uk
5. Side effects
Like all medicines, risperidone can cause side effects, although not everyone gets them.
Common side effects
These common side effects may affect up to 1 in 10 people.
Call your doctor or pharmacist if these side effects bother you or do not go away:
- feeling sleepy in the day or difficulty falling asleep at night
- problems with your movement – difficulty moving, stiff muscles with movements which are difficult to control, a slow shuffling walk, shakes and drooling – this is known as dyskinesia
- headaches
- putting on weight or changes in appetite
- stomach pain
- feeling or being sick (nausea or vomiting)
- constipation
- diarrhoea
- swollen breasts, pain in your breast or leaking breast milk – these can be signs of hormone changes
Serious side effects
Serious side effects are rare and happen in less than 1 in 1,000 people.
Urgent advice: Contact your doctor now if:
- you get twitching or jerking movements that you cannot control in your face, tongue, or other parts of your body
- you get swelling, pain and redness in the leg or chest pain with difficulty breathing – all these may be signs of blood clots in your veins
- you have a high temperature, muscle stiffness, sweating, anxiety or excess saliva – these may be signs of a disorder called neuroleptic malignant syndrome
Immediate action required: Call 999 or go to A&E if:
- you have weakness on one side of your face and body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke
- you have a fast heartbeat
- you have difficulty breathing
- you have had a seizure or fit
- you have a painful erection that lasts more than 2 hours (priapism)
If you need to go to A&E, do not drive yourself.
Get someone else to drive you or call for an ambulance. Take the risperidone packet or leaflet inside it plus any remaining medicine with you.
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to risperidone.
Immediate action required: Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of risperidone.
For a full list see the leaflet inside your medicines packet.
Information:
You can report any suspected side effect using the Yellow Card safety scheme.
Visit Yellow Card for further information.
6. How to cope with side effects of risperidone
What to do about:
- feeling sleepy – do not drive, ride a bike or use tools or machinery if you feel sleepy. As your body gets used to risperidone, this side effect should wear off. If it does not go after a few weeks, speak to your doctor.
- problems with your movement – speak to your doctor if these bother you or do not go away. Your doctor may be able to change your medicine.
- headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if headaches last longer than a week or are severe.
- putting on weight or changes in appetite – try to eat a healthy balanced diet without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you feel hungry between meals, eat fruit and vegetables and low-calorie foods. Regular exercise will also help to keep your weight stable.
- stomach pain – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.
- feeling or being sick – stick to simple meals and do not eat rich or spicy food. It might help to take your risperidone after you've had a meal or snack. If you're being sick, try having small, frequent sips of water or squash to avoid dehydration. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.
- constipation – eat more high-fibre foods such as fresh fruit and vegetables and cereals. Try to drink several glasses of water or squash every day. If you can, it may also help to increase your level of exercise. Watch a short video on how to treat constipation.
- diarrhoea – drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. Speak to a doctor if symptoms get worse or last longer than a week.
- swollen breasts, pain in your breast or leaking breast milk – speak to your doctor if these side effects last longer than a few days. Your doctor may be able to change your medicine.
7. Pregnancy and breastfeeding
Risperidone and pregnancy
Risperidone can be taken during pregnancy, although there is not much information to say how safe it is.
There may be a very small risk to your baby. However, the risk of you becoming unwell if you stop taking your medicine is much greater than the risk of harm to your baby.
For this reason, you will usually be advised to keep taking risperidone in pregnancy. Talk to your doctor about your treatment as soon as possible.
You may be asked to attend a specialist antenatal clinic with a pregnancy specialist (obstetrician) and mental health doctor or nurse.
Do not stop taking your medicine unless your doctor tells you to.
Risperidone and breastfeeding
If your doctor or health visitor says your baby is healthy, you can take risperidone while breastfeeding.
Risperidone passes into breast milk in small amounts and has been linked with side effects in very few breastfed babies. It has been used by many breastfeeding mothers without any problems.
It's important to continue taking risperidone to keep you well. Breastfeeding will also benefit both you and your baby.
If you notice that your baby is not feeding as well as usual, seems unusually sleepy, or seems irritable, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding
For more information, read how risperidone can affect you and your baby during pregnancy on the Best Use of Medicines in Pregnancy (BUMPS) website.
8. Cautions with other medicines
There are some medicines that may affect how risperidone works. Tell your doctor or pharmacist if you are taking:
- rifampicin (an antibiotic for treating tuberculosis (TB))
- carbamazepine or phenytoin (medicines for epilepsy)
- itraconazole (a medicine for treating fungal infections)
- medicines that make you feel sleepy such as diazepam (benzodiazepines), morphine or tramadol (opioid painkillers) or chlorphenamine (an antihistamine) – risperidone can increase these sedating effects and make you feel more sleepy
- medicines that cause a slow heartbeat
- medicines to treat high blood pressure
- medicines for Parkinson's disease such as levodopa
- medicines that stimulate the brain such as methylphenidate
- medicines that make you pee more (diuretics) such as furosemide or chlorothiazide
Mixing risperidone with herbal remedies and supplements
There might be a problem taking some herbal remedies and supplements alongside risperidone, especially ones that make you feel sleepy or dizzy.
Ask your pharmacist for advice.
While you are taking risperidone, do not take:
- St John's wort, a herbal remedy for depression – it may stop risperidone working as well as it should
- ginkgo biloba – this can increase the side effects of risperidone
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions about risperidone
How does risperidone work?Risperidone belongs to a group of medicines called antipsychotics.
It does not cure your condition but it can help the symptoms.
Risperidone works by affecting chemical messengers in your brain (neurotransmitters) like dopamine.
If you have too much dopamine it can make you see things that are not there (hallucinations) or think things that are not true (delusions). Dopamine is also involved in muscle movements so too much of it can also affect your muscles.
Risperidone also works on other neurotransmitters such as serotonin and noradrenaline. These are believed to control mood.
Taking risperidone will not change your personality and it is not addictive.
How long does it take to work?Risperidone, like many medicines, does not work straight away. It can take several days or even months for some symptoms to get better.
It may take a few weeks to get to the right dose for you.
How long will I take it for?This will depend on why you need risperidone:
- schizophrenia – you may need to take risperidone long-term
- mania due to bipolar disorder – you may need to take risperidone for a few weeks or months
- aggressive or agitated behaviour – you may only need risperidone for a short time
Keep taking risperidone even if you feel better unless your doctor asks you to stop.
Talk to your doctor first if you want to stop taking it for any reason.
How will it make me feel?You may find risperidone makes you:
- feel calmer and less upset
- able to concentrate better and think more clearly
- able to get things done and stay focussed
- more aware of what may and may not be real
- stop hearing voices
- remember things more easily
- feel more comfortable with other people and get along better with them
Yes, many people take risperidone for a long time.
Risperidone treats your condition but it will not cure it. It helps to keep your symptoms under control.
One long-term side effect can be putting on weight as taking risperidone can make you feel more hungry than usual.
If you're worried about long-term side effects then talk to your doctor.
What will happen if I stop taking it?Talk to your doctor if you want to stop taking risperidone.
If you need to stop taking risperidone your doctor will help you reduce your dose so that you come off the medicine gradually.
If you and your doctor agree that you can stop taking risperidone suddenly then your symptoms may come back. You may also get withdrawal symptoms such as feeling or being sick, sweating and difficulty sleeping.
Talk to your doctor or your specialist if you have any problems when you reduce your dose or stop taking risperidone.
Can I drink alcohol with it?It's best not to drink alcohol for the first few days of treatment until you see how the medicine affects you.
If you drink alcohol while taking risperidone it may make you feel sleepy and unsteady on your feet.
Drinking alcohol every day or in large amounts can make your symptoms worse. It also makes it harder for risperidone to work properly.
Will I gain or lose weight?Risperidone can make you feel more hungry than usual, so you may put on weight.
Try to eat a healthy balanced diet without increasing your portion sizes.
Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you feel hungry between meals, eat fruit and vegetables and low-calorie foods.
If you start to have problems with your weight while taking risperidone, talk to your doctor or pharmacist.
Is there any food or drink I need to avoid?Apart from limiting alcohol, you can eat and drink normally while taking risperidone.
However, risperidone can make you feel hungrier and put on weight.
If you have an increased appetite, try to eat a healthy balanced diet without increasing your portion sizes.
Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you feel hungry between meals, eat fruit and vegetables and low-calorie foods.
Will it affect my contraception?Risperidone will not affect any type of contraception, including the combined pill or emergency contraception.
However, if risperidone makes you sick (vomit) or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Find out what to do if you're on the pill and you're being sick or have diarrhoea.
Will it affect my fertility?Risperidone can affect your hormones and sometimes causes sexual problems (in men or women). It can also affect periods.
These effects are not common and happen in less than 1 in 100 people.
If you would like to start a family then talk to your doctor if you have any of these problems or if you are worried.
Can I drive or ride a bike?Risperidone can make you feel sleepy. If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel better.
Some people cannot concentrate properly while they are taking risperidone. When you first start taking risperidone, it's a good idea to stop driving and cycling for the first few days until you know how it makes you feel.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking risperidone.
GOV.UK has more information on the law on drugs and driving.
Risperidone: 7 things you should know
Print SaveMedically reviewed by Carmen Fookes, BPharm. Last updated on Aug 17, 2022.
1. How it works
- Risperidone may be used to treat psychotic symptoms, schizophrenia, bipolar I disorder, or to relieve symptoms of autistic disorder in children.
- Experts are not sure exactly how risperidone works but suggest that its main effects are the result of it blocking both dopamine and serotonin receptors. Other effects may be due to blocking other neurotransmitter receptors.
- Risperidone belongs to the class of medicines called atypical antipsychotics. Atypical means it is less likely than older antipsychotics to cause extrapyramidal side effects.
2. Upsides
- Relieves psychotic symptoms such as hallucinations, delusions, confusion, disturbed thoughts, and lack of insight or self-awareness.
- Used either alone or in combination with other medicines for the treatment of schizophrenia, acute mania, or mixed episodes in bipolar disorder.
- May be used in addition to lithium or valproate when used for acute manic or mixed episodes associated with Bipolar I disorder.
- Risperidone in small dosages may be also used to relieve irritability and symptoms of aggression, temper tantrums, and mood fluctuations in children and adolescents aged 5 to 17 years with autistic disorder.
- Not a controlled substance.
- Generic risperidone is available.
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Drowsiness that may affect your ability to drive or operate machinery. Avoid alcohol.
- Extrapyramidal symptoms (such as restlessness, tremor, uncontrolled muscle contractions) are more likely at dosages greater than 6mg/day.
Higher dosages have also not been associated with extra efficacy. Dosages for adolescents should be limited to 3mg/day to limit the risk of side effects. - Other common side effects include anxiety, blurred vision, dizziness, gastrointestinal disturbances (nausea, vomiting, constipation, diarrhea, dyspepsia, pain), excessive salivation, tiredness, weight gain, and rash. Uncommonly, a reduction in the numbers of white blood cells, swallowing difficulty, priapism (sustained erections), and seizures may occur.
- A drop in blood pressure on standing, particularly during the initial dose-titration period; dosage may need to be reduced then titrated up slowly. May not be suitable for people with known cardiovascular disease (history of a heart attack, angina, heart failure, or arrhythmia), stroke, and people at risk of dehydration.
- An increase in blood sugar levels. People with a history of diabetes or at risk of diabetes should be monitored closely. May also cause undesirable changes in blood cholesterol and lipid levels and weight gain (on average, 4.
3kg after 6 months of therapy). - An increase in prolactin levels (risk is higher than with most other antipsychotics), leading to side effects such as impaired fertility, an absence of menstruation, unwanted lactation, breast enlargement in men, impotence, and decreased bone density. May not be suitable for people with a history of prolactin-dependent breast cancer.
- Potentially irreversible tardive dyskinesia, even with low dosages that have only been taken for a short period. Symptoms include facial grimacing, repetitive chewing, and tongue thrusting.
- May interact with some medicines. Dosage may need increasing when used with enzyme inducers such as carbamazepine or phenytoin; dosage may need reducing when used with enzyme inhibitors such as fluoxetine or paroxetine. See the prescribing information for risperidone for the full list of interactions.
- Should not be used for the treatment of dementia-related psychosis in elderly people because risperidone has been associated with a higher risk of death.
- Rarely, may cause Neuroleptic Malignant Syndrome; symptoms include high body temperature, muscle rigidity, and mental disturbances; discontinue immediately and seek urgent medical advice.
- There are no controlled studies investigating the use of risperidone in pregnant women. Neonates exposed to antispsychotic agents, such as risperidone, in the third trimester are at risk for extrapyramidal or withdrawal symptoms following delivery. Only use in pregnancy if the potential benefits justify the risk. Risperidone and its metabolites are present in breast milk, and breastfeeding while taking risperidone is not recommended.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
- Risperidone is an antipsychotic that relieves psychotic symptoms in people with schizophrenia or mania and is also used in the treatment of autistic disorder.
Side effects are less likely at lower dosages and risperidone should not be used for the treatment of people with dementia-related psychosis.
5. Tips
- Risperidone should be started at a lower dose initially then gradually titrated up depending on an individual's response and tolerability. Follow your doctor's instructions.
- Some people are more sensitive to the effects of risperidone and may need a more gradual increase in dosage - talk with your doctor if you are having trouble tolerating any side effects of risperidone.
- Splitting the daily dose into a morning and evening dose may help reduce symptoms of drowsiness in people with persistent drowsiness.
- Risperidone may cause drowsiness and you should not drive or operate machinery if risperidone has this effect on you. Avoid alcohol as it may potentiate the sedative effect of risperidone.
- Risperidone may be used long-term; however, a doctor should periodically reevaluate its effectiveness and monitor you for side effects.
When used to delay relapse in people with schizophrenia, effectiveness in trials has lasted for at least 2 years (the duration of the trial). - Risperidone may make you feel dizzy when going from a sitting or lying down position to standing. This may increase your risk of falls. Stand up slowly and remove any fall hazards from your home (such as loose rugs).
- Talk with your doctor if you develop any worrying side effects such as uncontrollable facial grimacing, restlessness, severe dizziness, or severe abdominal discomfort.
- Tell your doctor if you are intending to become pregnant and you are taking risperidone because your doctor may wish to change you to a different medication before you fall pregnant. Risperidone is incompatible with breastfeeding.
6. Response and effectiveness
- Some effects may be noticed within a few days but it may take up to three to four weeks for the full effects of risperidone to be seen.
- Risperidone is metabolized to an active metabolite, 9-hydroxy-risperidone.
- Risperidone orally disintegrating tablets, risperidone oral solution, and risperidone tablets are all bioequivalent (this means that there is no difference in the extent to which they are absorbed and their effect).
7. Interactions
Medicines that interact with risperidone may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with risperidone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with risperidone include:
- antidepressants such as citalopram, escitalopram, or fluoxetine
- antipsychotics such as aripiprazole, clozapine or haloperidol
- azelastine
- bupropion
- clozapine
- cisapride
- CYP2D6 inhibitors or inducers, such as fluoxetine
- CYP3A4 inducers, such as carbamazepine, oxcarbazepine, phenytoin, rifampin, St John's Wort
- CYP3A4 inhibitors, such as clarithromycin, cyclosporine, fluconazole, ketoconazole, nefazodone, ritonavir, tamoxifen, verapamil
- diuretics, such as furosemide or hydrochlorothiazide
- droperidol
- heart medications, such as amlodipine, betaxolol, candesartan, carisprodol
- HIV medications, such as indinavir, nelfinavir, ritonavir, and saquinavir
- insulin
- ipratropium or tiotropium
- glucagon
- kava kava
- lithium
- magnesium sulfate
- medications used to treat Parkinson's Disease, such as cabergoline and levodopa
- nitroglycerin
- opioids, such as alfentanil, fentanyl, buprenorphine, methadone, or oxycodone
- pimozide
- potassium chloride
- QT-prolonging medications, such as amiodarone, clarithromycin, domperidone, flupentixol, sotalol or voriconazole
- tramadol
- valproate
- zolpidem.
Avoid drinking alcohol or taking illegal or recreational drugs while taking risperidone.
Note that this list is not all-inclusive and includes only common medications that may interact with risperidone. You should refer to the prescribing information for risperidone for a complete list of interactions.
More about risperidone
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- Dosage information
- During pregnancy
- Support group
- Drug class: atypical antipsychotics
- Breastfeeding
Patient resources
- Drug Information
- Risperidone injection
- Risperidone (Advanced Reading)
- Risperidone Intramuscular (Advanced Reading)
- Risperidone Injection (IM)
Other brands
Risperdal, Risperdal Consta, Perseris, Rykindo, Risperdal M-Tab
Professional resources
- Prescribing Information
Related treatment guides
- Anxiety
- Asperger Syndrome
- Agitation
- Autism
References
- Risperidone.
Revised 01/2022. AvKARE. https://www.drugs.com/pro/risperidone.html
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use risperidone only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2023 Drugs.com. Revision date: August 17, 2022.
Medical Disclaimer
Arpimed
If you are in any doubt if any of the above applies to you, talk to your doctor or pharmacist before using Risperidone.
Given that very rare cases of severe leukocytopenia have been observed with risperidone, the attending physician should periodically monitor the level of leukocytes in the blood.
Risperidone may cause weight gain. Significant weight gain can adversely affect your health. Your doctor should regularly measure your body weight.
Both the development of diabetes mellitus and the exacerbation of pre-existing diabetes have been noted in diabetic patients treated with risperidone, your doctor should monitor for symptoms of high blood sugar. In diabetic patients, blood glucose levels should be regularly monitored.
During eye surgery, the lens of the lens (cataract) may become cloudy and the pupil (the black circle in the center of your eye) may not enlarge as needed. In addition, the iris (the colored part of the eye) may become too flexible during surgery, which can damage the eye. If you are planning eye surgery, be sure to tell your doctor that you are taking Risperidone.
Elderly people with dementia
Older people with dementia have an increased risk of stroke. You should not take Risperidone if you have dementia due to a stroke.
Frequent visits to the doctor during treatment with risperidone.
Treatment should begin immediately if you or your caregiver notice a sudden change in mental state or sudden weakness or numbness of the face, arms or legs, especially on one side, or slurred speech, even for a short period of time.
They may be signs of a stroke.
Children and adolescents
Other causes of aggressive behavior must be ruled out before starting conduct disorder treatment.
If fatigue occurs during treatment with risperidone, changing the timing of dosing may eliminate difficulty concentrating.
Before starting treatment, you or your child's weight should be measured, which should be done regularly during treatment.
A small and incomplete study showed that there was an increase in height in children treated with risperidone, but whether this is the result of the drug or some other reason is not known.
Other medicines and Risperidone
Tell your doctor or pharmacist if you are taking, have recently taken or should take any other medicines.
It is especially important to check with your doctor or pharmacist if you are taking: drugs), as risperidone may increase their sedative effect, The following drugs may reduce the effect of risperidone If you start or stop taking these drugs, you may need to adjust your dose of risperidone. The following drugs may increase the effect of risperidone: If you start or stop taking these drugs, you may need to adjust your dose of risperidone. Co-administration of psychostimulants (eg, methylphenidate) with risperidone may result in extrapyramidal symptoms when the dose of one or both drugs is changed. If you have any doubts about taking this medicine, you should consult your doctor or pharmacist before taking it. Risperidone with food, drink and alcohol Risperidone can be taken with or without food. You should avoid drinking alcohol while taking Risperidone. Pregnancy and lactation Effects on ability to drive and use machines Dizziness, fatigue, and vision problems may occur during treatment with risperidone. In this case, you need to stop driving or working with any mechanisms and inform your doctor about it. Important information about the ingredients that make up Risperidone Risperidone film-coated tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, talk to your doctor before taking Risperidone. Risperidone should be taken exactly as prescribed by your doctor. If you have any doubts about taking the drug, you should consult your doctor or pharmacist before using Risperidone. Recommended doses Treatment of schizophrenia Adults Elderly patients For the treatment of mania Elderly patients Treatment of attacks of aggression in patients with Alzheimer's disease Adults (including the elderly) Application in children and adolescents Children and adolescents under 18 years of age is not allowed to use risperidone for the treatment of schizophrenia and mania Treatment of behavioral disorder 9000 Dosage depends on the weight For children weighing less than 50 kg: For children weighing 50 kg or more: The duration of treatment in patients with conduct disorder should not exceed 6 weeks. Do not use risperidone in children under 5 years of age for the treatment of conduct disorder Patients with kidney and liver problems Regardless of the disease being treated, all initial and subsequent doses of risperidone should be halved. Dose increases should be gradual in these patients. Risperidone should be used with caution in this group of patients. In psychiatry, sleep dysregulation is common in patients suffering from schizophrenia, mania, depression, delirium, suicidal ideation, mental disorders with irritability, delusions, agitation, aggression, and other mental disorders. Antipsychotics were originally called "master tranquilizers" because these compounds proved to be "sedative" in the treatment of psychosis, mania, agitation and aggression, and also had sedation and drowsiness as the main pharmacodynamic result (Welsh, 1964). Indeed, major tranquilizers have been found to modulate monoaminergic targets, including adrenergic, noradrenergic, dopaminergic, histaminergic, and serotonergic receptors, causing sedation and drowsiness. The following three antipsychotics were least associated with sedation and drowsiness (ROR crosses 2): prochlorperazine (n = 202) ROR = 1.4 (95% CI, 1.2–1.6), paliperidone (n = 641 ) ROR = 1.9 (95% CI). 1.8–2.0) and aripiprazole lauroxyl (n = 36) ROR = 2.1 (95% CI 1.5–3.0). Of note, like the haloperidol tablet formulation, the aripiprazole tablet formulation had a stronger association with sedation and drowsiness (n=2647) ROR = 3.7 (95% CI, 3.6–3.9) compared with long-acting injectables of the two compounds. Zuclopenthixol of all antipsychotics is most closely associated with sedation and drowsiness, and long-acting haloperidol decanoate injection (LAI) is not associated with sedation and drowsiness. Furthermore, among the atypical antipsychotics, tiapride and asenapine were the two main compounds most strongly associated with drowsiness. Typical antipsychotics are ligands that preferentially bind to dopamine D2 receptors, while atypical antipsychotics are ligands with higher binding affinity for different serotonin 5-HT receptor subtypes and can be dichotomized using the ratio of 5-HT2 binding to dopamine D2 . Antipsychotic biomarkers Electroencephalographic brain mapping studies demonstrate that antipsychotics are associated with delta frequency band and non-REM sleep through serotonin 5-HT2A and 5-HT2C receptors. Antipsychotics protect against covid Zuclopenthixol, an antipsychotic with a strong association with sedation and drowsiness, has emerged as a compound that demonstrates in vitro inhibition of the severe acute respiratory coronavirus 2 (SARS-CoV-2) pathogen that causes the novel coronavirus disease 2019 (COVID-19). (Bocci et al. 2020). A recent review article reported that thioridazine, fluphenazine, perphenazine, chlorpromazine, prochlorperazine inhibit RNA viruses because these phenothiazines inhibit cell-cell fusion, viral replication, clathrin-dependent endocytosis, and cell entry. Dyall and colleagues reported that triflupromazine suppresses the Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-1 (Dyall et al. Antipsychotics prevent cancer progression Another study showed that trifluoperazine inhibits lung metastasis, bone metastasis, and melanoma brain metastasis through the mechanism of G0/G1 cell cycle arrest and mitochondria-dependent intrinsic apoptosis. Using the same mechanism, another study reported that fluphenazine inhibited the growth of triple-negative breast cancer as well as lung and brain metastasis in a subcutaneous xenograft model. Another phenothiazine, perphenazine, inhibits the growth of progesterone receptor-resistant endometrial cancer. The anticancer properties of antipsychotics, in particular typical antipsychotics, have been described, which are associated with dopamine D2 receptor antagonist properties that disrupt important metabolic processes in tumors and cancer cells (Weissenrieder et al., 2019). Researchers in France reported that chlorpromazine, a methylene blue derivative, inhibits SARS-CoV-2 in vitro, and other studies have shown the clinical benefit of chlorpromazine in the most invasive glial tumor, grade IV astrocytoma, glioblastoma multiforme. Antipsychotics and antidepressants Antipsychotics are increasingly being used to enhance antidepressants. A classic example is the olanzapine/fluoxetine combination approved for the treatment of treatment-resistant depression and bipolar depression (Eli Lilly and Company, 2018). Fluoxetine is a potent inhibitor of CYP2C19 and CYP2D6 and increases the area-time curve (AUC) of sensitive CYP2C19 or CYP2D6 substrates by more than 5-fold. Moreover, fluoxetine enantiomer metabolites (R)-norfluoxetine and (S)-norfluoxetine cause time-dependent inhibition of CYP3A4 (Ki = 8 µM) and CYP2C19(Ki = 7 μM), respectively, and have been shown to inhibit SARS-Cov-2. In addition to being indicated for patients diagnosed with schizophrenia, quetiapine is indicated for patients diagnosed with manic episodes of bipolar I disorder and as monotherapy for bipolar depression. In addition, quetiapine is biotransformed by CYP3A4 to norquetiapine, which has a moderate binding affinity for the norepinephrine transporter (Ki = 12 nM), as found in some traditional antidepressant compounds.
Risperidone may lower blood pressure,
If a child develops any of these symptoms, a doctor should be consulted.
Your doctor can determine the dose that is best for you.
25 mg twice a day
5 mg once a day ✚ Drowsiness from neuroleptics. Neuropsychiatric clinic of Professor Minutko. Article #8995
Sedation and drowsiness leading to restful sleep are neuroprotective, and the growing interest in the reuse of antipsychotics in oncology and infectious diseases is meeting an unmet clinical need in medical sciences and patient care (Koyanagi and Stickley, 2015; Laskemoen et al., 2019). The most comprehensive study to date specifically focused on the assessment of drowsiness in antipsychotics was conducted by Fang and colleagues and included 12 compounds (Fang et al., 2016). In this study, which assessed the absolute risk of increased drowsiness, clozapine was classified as a drug with increased drowsiness, while olanzapine, perphenazine, quetiapine, risperidone and ziprasidone were classified as moderate drowsiness, and finally asenapine, aripiprazole , cariprazine, lurasidoline, haloperidone, and paliperidone have been classified as compounds with low sleepiness (Fang et al., 2016). To date, the most comprehensive study evaluating sedation is a network meta-analysis by Khan and colleagues, which found that of the thirty-two antipsychotics, zuclopenthixol has the highest risk of sedation (Huhn et al.
, 2019). 
Overall, typical (ROR = 5.05 [95% CI, 4.97–5.12]) antipsychotics were more strongly associated with sedation and drowsiness than atypical (ROR = 4.65 [95% CI, 4 ,47–4,84]) antipsychotics. 
Of note, other translational biomarker studies using prepulse inhibition have shown that sleep deprivation causes "perceptual distortion" (eg, auditory hallucinations), cognitive disorganization, and anhedonia in healthy adults. 
, 2014). 
Methylene blue, the first synthetic compound in medicine, has anti-malarial, anti-SARS-Cov-2 properties, and a recent study found the compound to have neuroprotective properties. Other drug repurposing efforts have identified haloperidol, a typical antipsychotic that is a sigma-1 and sigma-2 receptor ligand, also inhibits SARS-Cov-2 in vitro (Gordon et al., 2020). 
Olanzapine is a CYP1A2 substrate and should not be given with strong CYP1A2 inhibitors to avoid excessive increases in AUC and Cmax. For example, fluvoxamine is a strong inhibitor of CYP1A2 and CYP2C19 and can lead to drug interactions that increase the AUC of asenapine, chlorpromazine, clozapine, olanzapine, and thiothixene. Among antipsychotics, aripiprazole, brexpiprazole, and quetiapine are also used as adjunctive antidepressants. Both aripiprazole and brexpiprazole are substrates of CYP2D6 and may result in drug interactions (DDI) when combined with fluoxetine, paroxetine, sertraline, bupoprion and duloxetine since antidepressants are inhibitors of CYP2D6. 
