From the Guidelines
Risperidone (Risparidona in Spanish) is an antipsychotic medication that should be used with caution due to its potential for weight gain and extrapyramidal symptoms, and the typical starting dose for adults with schizophrenia is 1-2 mg per day, gradually increasing to an effective dose of 4-6 mg daily, divided into one or two doses, as recommended by the most recent guidelines 1.
Key Considerations
- The medication works by blocking dopamine D2 receptors and serotonin 5-HT2A receptors in the brain, helping to reduce hallucinations, delusions, and disorganized thinking.
- Patients should be monitored for metabolic changes (weight, blood glucose, lipids), extrapyramidal symptoms, and prolactin elevation.
- The medication should be taken consistently, and patients should not stop taking it abruptly without medical supervision as this can lead to withdrawal symptoms or symptom recurrence.
- Risperidone is consistently associated with weight gain, and studies demonstrate that patients may lose weight and develop improved glucose tolerance when switched from olanzapine to ziprasidone 1.
Dosage and Administration
- The typical starting dose for adults with schizophrenia is 1-2 mg per day, gradually increasing to an effective dose of 4-6 mg daily, divided into one or two doses.
- For elderly patients or those with renal or hepatic impairment, lower starting doses of 0.25-0.5 mg twice daily are recommended with more gradual titration.
Side Effects and Monitoring
- Common side effects include drowsiness, increased appetite, weight gain, and movement disorders.
- Patients should be monitored for metabolic changes, extrapyramidal symptoms, and prolactin elevation.
- The medication should be used with caution in patients with a history of seizures, as it may lower the seizure threshold 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY SECTION 12. 1 Mechanism of Action The mechanism of action of RISPERIDONE, in schizophrenia, is unknown. However, it has been proposed that the drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D2) and serotonin Type 2 (5HT2) receptor antagonism
- Main Mechanism: The therapeutic activity of RISPERIDONE is thought to be mediated through dopamine Type 2 (D2) and serotonin Type 2 (5HT2) receptor antagonism.
- Key Points:
- RISPERIDONE has high affinity for serotonin Type 2 (5HT2) and dopamine Type 2 (D2) receptors.
- The clinical effect of RISPERIDONE results from the combined concentrations of risperidone and its major metabolite, 9-hydroxyrisperidone.
- Antagonism at receptors other than D2 and 5HT2 may explain some of the other effects of RISPERIDONE 2.
From the Research
Información general sobre Risparidona
- La risperidona es un antipsicótico atípico utilizado para tratar la esquizofrenia y otros trastornos psicóticos 3, 4.
- Los estudios han demostrado que la risperidona es efectiva en el tratamiento de síntomas positivos y negativos de la esquizofrenia, con un perfil de efectos secundarios superior a los neurolépticos estándar 4.
Dosis y administración
- La dosis recomendada de risperidona es de 4 mg/día para la mayoría de los pacientes, con una titración más lenta que la recomendada anteriormente 3.
- Para pacientes ancianos, jóvenes y de primer episodio, se puede considerar una dosis más baja y una titración más lenta 3.
- Un estudio encontró que una dosis de carga rápida de risperidona es bien tolerada en la mayoría de los pacientes psiquiátricos 5.
Comparación con otros antipsicóticos
- La risperidona se ha comparado con la quetiapina en varios estudios, y se ha encontrado que ambas son efectivas en el tratamiento de síntomas psicóticos 6, 7.
- La quetiapina puede tener un perfil de efectos secundarios más favorable que la risperidona, con una menor incidencia de síntomas extrapiramidales y un menor riesgo de aumento de peso 6, 7.
- Un estudio encontró que la quetiapina es más efectiva que la risperidona en el tratamiento de síntomas depresivos 7.