What is the best way to taper off Risperidone (risperidone) 1mg twice daily (bid)?

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Last updated: June 17, 2025View editorial policy

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From the Research

Tapering off risperidone 1mg twice daily should be done gradually under medical supervision, with a recommended reduction of one quarter of the most recent dose every 3-6 months, to minimize withdrawal symptoms and prevent relapse of the condition being treated. This approach is supported by the most recent and highest quality study, which suggests that a hyperbolic tapering method can reduce the risk of relapse by allowing underlying adaptations time to resolve 1.

Key Considerations

  • The tapering process should be individualized, taking into account the patient's tolerance and medical history.
  • Monitoring for withdrawal symptoms such as insomnia, anxiety, agitation, or return of original symptoms is crucial during the tapering process.
  • The gradual reduction allows the brain to adjust to decreasing levels of the medication, as risperidone affects dopamine and serotonin receptors that the brain has adapted to over time.
  • Never stop risperidone abruptly, as this can lead to uncomfortable withdrawal effects and potential symptom rebound.

Tapering Schedule

  • Start by reducing the dose by one quarter of the most recent dose (e.g., from 1mg twice daily to 0.75mg twice daily) every 3-6 months.
  • Continue to reduce the dose by one quarter of the most recent dose every 3-6 months, until the final dose is as small as 1/40th of the therapeutic dose.
  • If significant difficulties are experienced during the taper, the doctor may adjust the schedule to make it more gradual or temporarily pause at a certain dose until side effects subside.

Importance of Medical Supervision

  • Tapering off risperidone should only be done under the guidance of a medical professional, as they can monitor the patient's progress and adjust the tapering schedule as needed.
  • Medical supervision can help minimize the risk of relapse and ensure a safe and successful tapering process.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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