From the Guidelines
Risperidone belongs to the atypical antipsychotic drug class, also known as second-generation antipsychotics. It works primarily by blocking dopamine D2 receptors and serotonin 5-HT2A receptors in the brain, which helps control symptoms of various psychiatric conditions. Unlike first-generation antipsychotics, risperidone generally causes fewer extrapyramidal side effects (movement disorders) at therapeutic doses, though these can still occur, especially at higher doses. Risperidone is commonly prescribed to treat schizophrenia, bipolar disorder, irritability associated with autism, and sometimes used off-label for severe behavioral problems, aggression, or Tourette's syndrome. The medication comes in various forms including tablets, oral solution, orally disintegrating tablets, and long-acting injectable formulations. Common side effects include weight gain, increased prolactin levels, sedation, and metabolic changes. Regular monitoring of metabolic parameters, movement disorders, and prolactin-related side effects is important during treatment with risperidone.
Key Points
- Risperidone is an atypical antipsychotic with a unique mechanism of action, involving the blockade of dopamine D2 and serotonin 5-HT2A receptors 1.
- It is used to treat a range of psychiatric conditions, including schizophrenia, bipolar disorder, and irritability associated with autism 1.
- Risperidone has a lower risk of extrapyramidal side effects compared to first-generation antipsychotics, but can still cause these side effects, especially at higher doses 1.
- Common side effects include weight gain, increased prolactin levels, sedation, and metabolic changes, which require regular monitoring 1.
Clinical Considerations
- Risperidone is available in various formulations, including tablets, oral solution, orally disintegrating tablets, and long-acting injectable formulations.
- The medication should be used with caution in patients with a history of cardiovascular disease, as it can cause changes in blood pressure and heart rate.
- Regular monitoring of metabolic parameters, movement disorders, and prolactin-related side effects is essential during treatment with risperidone.
From the FDA Drug Label
RISPERIDONE contains risperidone, an atypical antipsychotic belonging to the chemical class of benzisoxazole derivatives. The drug class of Risperidone is an atypical antipsychotic [ 2 ].
- Main drug class: Atypical antipsychotic
- Chemical class: Benzisoxazole derivatives
From the Research
Drug Class of Risperidone
Risperidone is classified as an atypical antipsychotic, which is a class of drugs used to treat psychiatric conditions such as schizophrenia, bipolar disorder, and irritability associated with autism.
Characteristics of Atypical Antipsychotics
Atypical antipsychotics, including risperidone, are characterized by their ability to block both serotonin 5-HT2 and dopamine D2 receptors in the brain, which is thought to contribute to their therapeutic effects 3.
Comparison with Other Atypical Antipsychotics
Studies have compared the efficacy and tolerability of risperidone with other atypical antipsychotics, such as clozapine, olanzapine, and quetiapine. These studies have found that risperidone is generally as effective as other atypical antipsychotics in treating schizophrenia and other conditions, but may have a different side effect profile 4, 5.
Key Points
- Risperidone is an atypical antipsychotic that blocks serotonin 5-HT2 and dopamine D2 receptors
- It is used to treat schizophrenia, bipolar disorder, and irritability associated with autism
- Risperidone has a different side effect profile compared to other atypical antipsychotics, such as clozapine and olanzapine
- It is considered a first-line treatment for acute and chronic schizophrenia due to its balance of efficacy, safety, tolerability, and cost-effectiveness 6
Evidence from Studies
- A study published in 2000 found that risperidone was as effective as clozapine in treating treatment-resistant schizophrenia, but had a higher rate of extrapyramidal side effects 4
- A study published in 2011 found that risperidone was less efficacious than olanzapine in terms of leaving the study early due to inefficacy, but was more efficacious than ziprasidone in the same outcome 5
- A review published in 2012 found that risperidone was associated with benefits in the treatment of elderly patients with dementia, but was also associated with an increased risk of adverse events, such as extrapyramidal symptoms and urinary symptoms 7