From the Guidelines
Risperidone can cause Akathisia (AMS), a type of extrapyramidal symptom, which is characterized by a sense of severe restlessness and physical agitation. This side effect is commonly seen in patients treated with antipsychotics, including risperidone, and can be misinterpreted as psychotic agitation or anxiety 1. According to the American Academy of Child and Adolescent Psychiatry, akathisia is a common reason for medication noncompliance and can be difficult to treat 1.
The mechanism of action of risperidone, which blocks dopamine receptors in the brain, particularly in the nigrostristral pathway, can disrupt the balance between dopamine and acetylcholine, leading to extrapyramidal symptoms such as akathisia 1. The risk of experiencing akathisia is dose-dependent, with higher doses increasing the likelihood of this side effect.
If a patient experiences akathisia while taking risperidone, the healthcare provider may attempt to lower the antipsychotic dose, as this can help alleviate symptoms 1. Additionally, antiparkinsonian agents, β-blockers, and benzodiazepines may be prescribed to manage akathisia, although their effectiveness can vary 1. It is essential to note that patients should not stop taking risperidone suddenly without medical supervision, as this can lead to withdrawal symptoms or worsening of the underlying condition being treated.
Key points to consider:
- Risperidone can cause akathisia, a type of extrapyramidal symptom
- The risk of akathisia is dose-dependent, with higher doses increasing the likelihood of this side effect
- Lowering the antipsychotic dose, or using antiparkinsonian agents, β-blockers, and benzodiazepines may help manage akathisia
- Patients should not stop taking risperidone suddenly without medical supervision 1.
From the FDA Drug Label
Akathisia includes akathisia and restlessness. Akathisia* 10 10 3 Akathisia* 9 3 Akathisia* 9 3 Akathisia includes hyperkinesia and akathisia Akathisia* 8 0 Akathisia includes restlessness and akathisia
Yes, Risperidone can cause Akathisia (AMS) 2.
- Key points:
- Akathisia is reported in 2% or more of RISPERIDONE-treated adult patients with schizophrenia and bipolar mania.
- Akathisia is also reported in 5% or more of RISPERIDONE-treated pediatric patients with schizophrenia and bipolar mania.
From the Research
Risperidone and Akathisia
- Risperidone can cause Akathisia (AMS) as a side effect, as evidenced by studies that have investigated the prevalence of extrapyramidal symptoms in patients treated with antipsychotics 3, 4, 5, 6, 7.
- The point-prevalence of akathisia was found to be 13% in patients treated with risperidone, which is lower than that of conventional antipsychotics but higher than that of clozapine 3.
- Akathisia is characterized by psychomotor restlessness and the inability to remain motionless, and its incidence and prevalence range from 5 to 50% among patients treated with antipsychotics 5.
- Risperidone-induced tardive akathisia is a rare side effect, and there is limited literature available on its management 7.
- The development of akathisia is likely due to the blockage of dopaminergic receptors, and individual susceptibility may play a major role in its occurrence 5.