From the Guidelines
Risperidone is an atypical antipsychotic medication.
Key Characteristics
- It is used to target symptoms such as irritability, aggression, hyperactivity, and disruptive behaviors in children and adolescents with intellectual disability (ID) or intellectual developmental disorder (IDD) 1.
- The medication has been shown to improve symptoms of conduct disorder (CD) and oppositional defiant disorder (ODD) in this population 1.
- Common side effects of risperidone include somnolence, headache, weight gain, and asymptomatic increases in prolactin 1.
Dosage and Administration
- The mean dose of risperidone used in studies ranged from 1.16 mg/d to 2.9 mg/d, with treatment durations varying from 4 weeks to 6 weeks 1.
- In some cases, risperidone was used in combination with other medications, such as stimulants, to manage symptoms of hyperactivity and inattention 1.
Clinical Considerations
- Risperidone is generally considered effective for managing irritability and aggression in children and adolescents with ID/IDD, but its use should be carefully weighed against potential side effects and considered after assessments of whether nonpharmacological means can address contributing factors 1.
From the FDA Drug Label
RISPERIDONE contains risperidone, an atypical antipsychotic belonging to the chemical class of benzisoxazole derivatives. The chemical designation is 3-[2-[4-(6-fluoro-1,2-benzisoxazol-3-yl)-1-piperidinyl]ethyl]-6,7,8,9-tetrahydro-2-methyl-4H-pyrido[1,2-a]pyrimidin-4-one.
Risperidone is an atypical antipsychotic belonging to the chemical class of benzisoxazole derivatives 2.
- It has a chemical designation of 3-[2-[4-(6-fluoro-1,2-benzisoxazol-3-yl)-1-piperidinyl]ethyl]-6,7,8,9-tetrahydro-2-methyl-4H-pyrido[1,2-a]pyrimidin-4-one.
- Its molecular formula is C23H27FN4O2 and its molecular weight is 410.49.
From the Research
Definition and Mechanism of Risperidone
- Risperidone is a benzisoxazole derivative with antipsychotic activity, chemically unrelated to other currently available antipsychotic agents 3.
- It has potent central antagonism of both serotonin 5-HT2 and dopamine D2 receptors, differing from most other antipsychotic drugs 3.
- Risperidone is a second-generation antipsychotic (SGA) for the treatment of schizophrenia and other psychotic disorders, acting as a potent antagonist of serotonin-2 (5-HT2) and dopamine-2 (D2) receptors in the brain 4.
Clinical Uses of Risperidone
- Initially approved for the treatment of schizophrenia, risperidone is now used in many countries to treat other conditions, including bipolar disorder, dementia, and behavior problems in various age groups 5.
- It has been shown to be effective in acute schizophrenia and in non-treatment-resistant schizophrenics, with potential value in patients with schizodepressive disorders 3.
- Risperidone is also used off-label by clinicians to treat other mood and anxiety disorders and behavioral disorders, although further randomized controlled trials are needed to confirm its efficacy and tolerability in these conditions 5.
Side Effects and Dosage of Risperidone
- Risperidone is associated with relatively few motor side effects compared to traditional antipsychotics, and weight gain is less likely with risperidone than with other atypical antipsychotics like clozapine or olanzapine 6.
- Increased prolactin levels have been reported in patients taking risperidone, but little correlation has been found between prolactin levels and adverse events 6.
- The optimal dose of risperidone is still a topic of research, with studies suggesting that low to standard-lower doses (2-6 mg/day) may be optimal for clinical response and adverse effects, while high doses (>10 mg/day) may cause more adverse effects, especially movement disorders 7.