II. Class

  1. Atypical Antipsychotic (Second Generation agent)
  2. Neuroleptic

III. Adverse Effects

  1. Insomnia
  2. Hypotension
  3. Weight gain
  4. Extrapyramidal Side Effects
    1. Low risk when daily dose under 10 mg
  5. Peristent Tardive Dyskinesia
    1. Lower Incidence than with other Neuroleptics
  6. Exacerbates Parkinson's Disease movement

IV. Dosing

  1. Initial
    1. Adult: 1 mg PO bid
    2. Elderly: 0.25 mg qd to 0.5 mg PO bid
  2. Slow titration to average dosing
    1. Adult: 2 to 4 mg PO daily (or divided bid)
    2. Elderly with Dementia: 0.5 to 0.75 mg PO bid
  3. Maximum: 16 mg/day

V. Monitoring

  1. See Antipsychotics
  2. Consider EKG, electrolyte and Magnesium monitoring due to QT Interval prolongation risk

VI. Drug Interactions

  1. Metabolized by Cytochrome P450 2D6
  2. Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
    1. Clozapine
    2. Fluoxetine
    3. Paroxetine
  3. Decrease Antipsychotic levels (lower efficacy)
    1. Barbiturates
    2. Carbamazepine
    3. Phenytoin
    4. Rifampin
  4. Other effects
    1. Increased antihypertensive effect (may result in Hypotension)
    2. Raises Prolactin levels
    3. Avoid concurrent use of other medications prolonging QT Interval
      1. See Prolonged QT Interval due to Medication

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Cost: Medications

risperidone (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
RISPERIDONE 0.25 MG TABLET Generic $0.06 each
RISPERIDONE 0.5 MG ODT Generic $0.78 each
RISPERIDONE 0.5 MG TABLET Generic $0.06 each
RISPERIDONE 1 MG ODT Generic $1.38 each
RISPERIDONE 1 MG TABLET Generic $0.08 each
RISPERIDONE 1 MG/ML SOLUTION Generic $0.37 per ml
RISPERIDONE 2 MG ODT Generic $1.73 each
RISPERIDONE 2 MG TABLET Generic $0.10 each
RISPERIDONE 3 MG ODT Generic $3.30 each
RISPERIDONE 3 MG TABLET Generic $0.10 each
RISPERIDONE 4 MG ODT Generic $5.69 each
RISPERIDONE 4 MG TABLET Generic $0.15 each
risperdal (on 1/6/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
RISPERDAL 0.25 MG TABLET Generic $0.06 each
RISPERDAL 0.5 MG TABLET Generic $0.06 each
RISPERDAL 1 MG TABLET Generic $0.08 each
RISPERDAL 1 MG/ML SOLUTION Generic $0.37 per ml
RISPERDAL 2 MG TABLET Generic $0.10 each
RISPERDAL 3 MG TABLET Generic $0.10 each
RISPERDAL 4 MG TABLET Generic $0.15 each
RISPERDAL CONSTA 12.5 MG SYR $189.61 each
RISPERDAL CONSTA 25 MG SYR $385.58 each
RISPERDAL CONSTA 37.5 MG SYR $576.05 each
RISPERDAL CONSTA 50 MG SYR $763.73 each

Ontology: Risperidone (C0073393)

Definition (CHV) a drug used to treat the symptoms of schizophrenia
Definition (NCI) A benzisoxazole derivative with antipsychotic property. Risperidone selectively antagonizes serotonin (5-HT) effects via cortical 5-HT2 receptor, and, to a lesser extent, competes with dopamine at the limbic dopamine D2 receptor. The antagonism leads to decreased psychotic effects, such as hallucinations and delusions. In addition, risperidone has low to moderate affinity for histamine H1, 5-HT1A, 5-HT1C, and 5-HT1D receptors, while it has weak affinity for dopamine D1 and haloperidol-sensitive sigma site receptors.
Definition (MSH) A selective blocker of DOPAMINE D2 RECEPTORS and SEROTONIN 5-HT2 RECEPTORS that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of SCHIZOPHRENIA.
Definition (CSP) selective blocker of dopamine D2 and serotonin-5-HT2 receptors that acts as an atypical antipsychotic agent; has been shown to improve both positive and negative symptoms in the treatment of schizophrenia.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D018967
SnomedCT 108386000, 386840002
LNC LP17872-0, MTHU014878
English 4H-Pyrido(1,2-a)pyrimidin-4-one, 3-(2-(4-(6-fluoro-1,2-benzisoxazol-3-yl)-1-piperidinyl)ethyl)-6 ,7,8,9-tetrahydro-2-methyl-, Risperidone, risperidone, risperidone (medication), RISPERIDONE, Risperidone [Chemical/Ingredient], risperiDONE, RisperiDONE, Risperidone (product), Risperidone (substance)
Swedish Risperidon
Czech risperidon
Finnish Risperidoni
Russian RISPERIDON, РИСПЕРИДОН
Japanese リスペリドン
Polish Rysperydon
Croatian RISPERIDON
Spanish risperidona (producto), risperidona (sustancia), risperidona, Risperidona
French Risperidone
German Risperidon
Italian Risperidone
Portuguese Risperidona

Ontology: Risperdal (C0592071)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Risperdal, risperdal, RisperDAL