(Legend)

Generic Name

• Risperidone
  T½ = Metabolizers: 3 h (9-hydroxy-risperidone, 21 h)
  Poor metabolizers: 20 h (9-hydroxy-risperidone, 30 h)
  Pregnancy category C

Trade Name

• Risperdal
• Risperdal M-Tab
• Risperdal Consta Long-acting Injection

Dose Range/Adult Daily Dose

• Range: 4–12 mg/d Dosing may be once/d (↑ risk of EPS w dose >6 mg)
  Schizophrenia: Start 1 mg po 2 × daily, ↑ to 3 mg 2 × daily (up to 16 mg/d).
  IM: 25 mg q 2 wk, may ↑ 37.5/50 mg.
  Bipolar Mania: 2–3 mg/d po (range: 1–5 mg/d)

Use/Common Side Effects (CSE)

• Use: Schizophrenia; bipolar: mania, acute or mixed; new indication: irritability associated with autism
  CSE: EPS (akathisia), dizziness, aggression, insomnia, sedation, dry mouth, pharyngitis, cough, visual disturbances, itching, skin rash, constipation, diarrhea, libido, weight gain/loss, NMS

Geriatric & Dose Considerations

• Warning: ↑ mortality in elderly with dementia-related psychosis
  Caution: Renal/hepatic disease/CV disease.
  Bipolar mania: Start 0.5 mg po 2 × daily, up to 1.5 mg 2 × daily (gradually increase weekly if necessary at small increments)

Classification

• Antipsychotic [Atypical]

Assessment Cautions

• Caution: Renal/hepatic impairment. Dosing may be once daily or bid and increments should be small (1 mg). Maximal effect seen with 4–8 mg/d, and doses above 6 mg/d not more efficacious, and with ↑ risk of EPS. Monitor BP, pulse during titration: may cause tachycardia, hypotension, QT prolongation. Establish oral dosing tolerance before using IM. Monitor BMI, FBS, and lipids.