risperidone (Risperdal)

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Introduction

Tradename: Risperdal.

Indications

Contraindications

pregnancy category = c

safety in lactation = -

Dosage

  • start 1 mg PO BID (lower initial dose in elderly)
  • usual effective dose is 4-6 mg/day
  • doses > 6 mg may not provide additional benefit, but do increase incidence of extrapyramidal symptoms
  • max 16 mg/day
  • injection 25-50 mg every 2 weeks
    • continue oral therapy for 3 weeks after 1st injection
  • elderly 0.5-2 mg PO daily

Tabs: 0.25, 1, 2, 3, 4 mg.

Injection: (Risperdal Consta) 25, 37.5, 50 mg vials[11]

Pharmacokinetics

elimination via liver

elimination via kidney

1/2life = 3-24 hours

protein binding = 90 %

Adverse effects

Drug interactions

Mechanism of action

More general terms

Additional terms

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 Department of Veterans Affairs, VA National Formulary
    restricted to psychiatry
  3. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  4. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  5. Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. Journal Watch 22(4):27, 2002 Csernansky et al, N Engl J Med 346:16, 2002
  7. 7.0 7.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  8. 8.0 8.1 http://www.fda.gov/medwatch/safety/2003/risperdal.htm
  9. 9.0 9.1 9.2 9.3 Risperdal and Cerebrovascular Adverse Events in Elderly Patients With Dementia Prescriber's Letter 10(5):29 2003 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=190507&pb=PRL (subscription needed) http://www.prescribersletter.com
    Brodaty H, Ames D, Snowdon J, Woodward M, Kirwan J, Clarnette R, Lee E, Lyons B, Grossman F. A randomized placebo-controlled trial of risperidone for the treatment of aggression, agitation, and psychosis of dementia. J Clin Psychiatry. 2003 Feb;64(2):134-43. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12633121
  10. 10.0 10.1 Prescriber's Letter 10(11):62 2003
  11. 11.0 11.1 11.2 Risperdal Consta (Long-acting Injectable Risperidone) Prescriber's Letter 10(12):70 2003 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=191212&pb=PRL (subscription needed) http://www.prescribersletter.com
  12. 12.0 12.1 12.2 Risperdal (Risperidone) for Bipolar Mania Prescriber's Letter 11(1):4 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200109&pb=PRL (subscription needed) http://www.prescribersletter.com
  13. 13.0 13.1 Journal Watch 25(12):96, 2005 Ballard C, Margallo-Lana M, Juszczak E, Douglas S, Swann A, Thomas A, O'Brien J, Everratt A, Sadler S, Maddison C, Lee L, Bannister C, Elvish R, Jacoby R. Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial. BMJ. 2005 Apr 16;330(7496):874. Epub 2005 Feb 18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15722369
    Gauthier S Drugs for Alzheimer's disease and related dementias. BMJ. 2005 Apr 16;330(7496):857-8. No abstract available. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15831849 <Internet> http://bmj.bmjjournals.com/cgi/content/full/330/7496/874
  14. 14.0 14.1 14.2 Correll CU et al Cardiometabolic Risk of Second-Generation Antipsychotic Medications During First-Time Use in Children and Adolescents JAMA. 2009;302(16):1765-1773 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19861668 <Internet> http://jama.ama-assn.org/cgi/content/short/302/16/1765
    Varley CK & McClellan J Implications of Marked Weight Gain Associated With Atypical Antipsychotic Medications in Children and Adolescents JAMA. 2009;302(16):1811-1812 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19861677 <Internet> http://jama.ama-assn.org/cgi/content/short/302/16/1811
  15. 15.0 15.1 15.2 Deprecated Reference
  16. 16.0 16.1 16.2 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  17. 17.0 17.1 Huybrechts KF et al Antipsychotic Use in Pregnancy and the Risk for Congenital Malformations. JAMA Psychiatry. Published online August 17, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27540849 <Internet> http://archpsyc.jamanetwork.com/article.aspx?articleid=2545072
    Wisner KL et al Use of Antipsychotics During PregnancyPregnant Women Get Sick
    Sick Women Get Pregnant. JAMA Psychiatry. Published online August 17, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27552366 <Internet> http://archpsyc.jamanetwork.com/article.aspx?articleid=2545069
  18. 18.0 18.1 Clapham E, Boden R, Reutfors J et al. Exposure to risperidone versus other antipsychotics and risk of osteoporosis-related fractures: A population-based study. Acta Psychiatr Scand 2019 Sep 23; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31545521 https://onlinelibrary.wiley.com/doi/full/10.1111/acps.13101

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