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Risperidone

Risperdal

RA
UR

Written by R. Author | Reviewed by Uche Ruth

Updated on June 01, 2024

Overview

Risperidone (Risperdal) is an atypical antipsychotic that's used to improve mood, thoughts, and behaviors in people with schizophrenia, bipolar disorder, and autism. It's taken by mouth, typically once or twice daily. Common side effects of risperidone (Risperdal) include sleepiness, movement problems, and weight gain. Risperidone (Risperdal) can interact with some medications, such as certain antidepressants or blood pressure medications. Taking these medications together can make certain side effects worse.

What is Risperidone (Risperdal) used for?

  • Schizophrenia - people ages 13 years and older
  • Manic or mixed episodes associated with bipolar I disorder - people ages 10 years and older
  • Irritability associated with autism - children ages 5 to 17 years old

How Risperidone (Risperdal) works

Risperidone (Risperdal) is an atypical antipsychotic. It's not completely known how risperidone (Risperdal) works, but it's thought to work by balancing out the levels of chemicals (dopamine and serotonin) in your brain to help control your thoughts, mood, and behaviors.

Strengths

Dropper

30ml of 1mg/ml

Orally disintegrating tab

0.25mg
0.5mg
1mg
2mg
3mg
4mg

Tablet

0.25mg
0.5mg
1mg
2mg
3mg
4mg

Dosages

Oral risperidone (Risperdal) is available as oral solution, dissolvable tablets, and tablets.

Your provider will determine you dose of risperidone (Risperdal) based on your condition and whether you have kidney or liver problems. They'll adjust your dose over time, if needed.

  • Schizophrenia
    • Adults: The typical starting dose is 2 mg by mouth daily. The typical maintenance dose ranges from 4 mg to 8 mg daily. The maximum daily dose is 16 mg.
    • Children (ages 13 to 17 years old): The typical starting dose is 0.5 mg by mouth daily. The typical maintenance dose is 3 mg daily. The maximum daily dose 6 mg.
  • Bipolar I disorder
    • Adults: The typical starting dose is 2 mg to 3 mg by mouth daily. The typical maintenance dose ranges from 1 mg to 6 mg daily. The maximum daily dose is 6 mg.
    • Children ages (10 to 17 years old): The typical starting dose is 0.5 mg by mouth daily. The typical maintenance dose ranges from 1 mg to 2.5 mg daily. The maximum daily dose is 6 mg.
  • Irritability associated with autism
    • Children ages (5 to 17 years old): Your child's provider will calculate the dose based on their body weight. The typical starting dose is 0.25 mg to 0.5 mg by mouth daily. The typical maintenance dose ranges from 0.5 mg to 1 mg daily. The maximum daily dose is 3 mg.

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Interactions

Risperidone (Risperdal) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Risperidone (Risperdal). Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Side-effects

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Adults:

  • Muscle stiffness, muscle tightening, difficulty with movement (25%)
  • Extreme sleepiness (11%)
  • Restlessness, trouble remaining still (9%)
  • Tremor (6%)
  • Dizziness (6%)
  • Nausea (5%)
  • Repetitive movements, abnormal postures (5%)

Children:

  • Extreme sleepiness (up to 56%)
  • Dizziness (up to 16%)
  • Nausea or vomiting (up to 16%)
  • Stomach pain (up to 16%)
  • Muscle stiffness, muscle tightening, difficulty with movement (up to 12%)
  • Heartburn (up to 10%)
  • Sore throat (up to 10%)

Other Side Effects

Adults:

  • Diarrhea
  • Drooling
  • Blurry vision
  • Stomach discomfort
  • Feeling tired or having low energy

Children:

  • Blurry vision
  • Diarrhea
  • Feeling more hungry
  • Restlessness, trouble remaining still
  • Repetitive movements, abnormal postures
  • Anxiety
  • Rash

Please note: Side effects listed here were reported by people taking risperidone for bipolar in clinical studies. The side effects you experience might differ if you're taking risperidone for a different condition.

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

  • Neuroleptic malignant syndrome: fever, sweating, stiff muscles, confusion, not aware of your surroundings, fast or irregular heartbeat
  • Stroke: numbness or weakness typically on one side of the body, loss of balance, headache, blurred vision, difficulty speaking
  • Dangerously high blood sugar: frequently thirsty, needing to urinate often, tiredness, nausea, vomiting, difficulty breathing, having fruity breath, having dry mouth
  • Serious infections: fever, headache, chills, body aches, cough, weakness
  • Seizures
  • Difficulty swallowing

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Aggressive behavior
  • Agitation
  • Anxiety
  • Changes in vision, including blurred vision
  • Difficulty concentrating
  • Difficulty speaking or swallowing
  • Inability to move the eyes
  • Increase in amount of urine
  • Loss of balance control
  • Mask-like face
  • Memory problems
  • Muscle spasms of the face, neck, and back
  • Problems with urination
  • Restlessness or need to keep moving (severe)
  • Shuffling walk
  • Skin rash or itching
  • Stiffness or weakness of the arms or legs
  • Tic-like or twitching movements
  • Trembling and shaking of the fingers and hands
  • Trouble sleeping
  • Twisting body movements

Less common

  • Back pain
  • Chest pain
  • Speech or vision problems
  • Sudden weakness or numbness in the face, arms, or legs
  • Rare
  • Confusion
  • Dizziness
  • Drowsiness
  • Extreme thirst
  • Fast, shallow breathing
  • Fast, weak heartbeat
  • Headache
  • Increased thirst
  • Lip smacking or puckering
  • Loss of appetite
  • Muscle cramps
  • Pale, clammy skin
  • Poor coordination
  • Prolonged, painful, inappropriate erection of the penis
  • Puffing of the cheeks
  • Rapid or worm-like movements of the tongue
  • Shivering
  • Talking, feeling, and acting with excitement and activity that cannot be controlled
  • Uncontrolled chewing movements
  • Uncontrolled twisting movements of neck, trunk, arms, or legs
  • Unusual bleeding or bruising
  • Unusual facial expressions or body positions
  • Incidence not known
  • Actions that are out of control
  • Bleeding gums
  • Bloating
  • Blood in the urine or stools
  • Bluish lips or skin
  • Change in mental status
  • Chills
  • Clay-colored stools
  • Clumsiness
  • Cold sweats
  • Constipation
  • Cool, pale skin
  • Cough
  • Dark or bloody urine
  • Decrease in the frequency of urination
  • Decrease in urine volume
  • Decreased awareness or responsiveness
  • Depression
  • Difficulty in passing urine (dribbling)
  • Dry mouth
  • Fainting
  • Fast or irregular heartbeat
  • Fever
  • Flushed, dry skin
  • Fruit-like breath odor
  • Hives
  • Hostility
  • Increased hunger
  • Increased urination
  • Indigestion
  • Irregular heartbeat, recurrent
  • Irritability
  • Large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • Loss of consciousness
  • Low body temperature muscle ache, twitching, or weakness
  • Nausea
  • Nervousness
  • Nightmares
  • Painful urination
  • Pains in the stomach, side, or abdomen, possibly radiating to the back
  • Pinpoint red spots on the skin
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Rapid weight gain
  • Seizures
  • Severe constipation
  • Severe sleepiness
  • Shakiness
  • Slurred speech
  • Stomach pain
  • Swelling of the face, ankles, or hands
  • Tightness in the chest
  • Troubled breathing
  • Unexplained weight loss
  • Unpleasant breath odor
  • Unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • Vomiting
  • Vomiting of blood
  • Weak or feeble pulse
  • Yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

  • Absent, missed, or irregular menstrual periods
  • Body aches or pain
  • Breast swelling or soreness
  • Dandruff
  • Darkening of skin color
  • Decreased interest in sexual intercourse
  • Dry skin
  • Ear congestion
  • Inability to have or keep an erection
  • Increase in body movements
  • Increased watering of the mouth
  • Joint pain
  • Loss in sexual ability, desire, drive, or performance
  • Loss of voice
  • Oily skin
  • Pain or tenderness around the eyes and cheekbones
  • Sneezing
  • Stopping of menstrual bleeding
  • Toothache
  • Unusual breast milk production
  • Weight loss
  • Incidence not known
  • Acne
  • Change in taste
  • Enlargement of the penis or testes
  • Growth of pubic hair
  • Loss of taste
  • Rapid increase in height
  • Sleepwalking
  • Thinning or loss of hair

Common Concerns

In a study, some people noticed their symptoms improving in 2 to 6 days after starting risperidone (Risperdal) for psychosis. In other studies involving people with bipolar or schizophrenia, people noticed their condition getting better within a month. Keep in mind that each person responds to risperidone (Risperdal) differently. It can take some time before you and your provider find a dose of risperidone (Risperdal) that works best for you. Talk with your provider if you're not sure whether this medication is working for you.
Talk with your provider to see how long you should continue taking risperidone (Risperdal). More research is needed to learn about the long-term effects of taking this medication. But a study showed that risperidone (Risperdal) was safe and continued to work well to control symptoms due to schizophrenia after a year of treatment. Your provider might have you continue taking risperidone (Risperdal) as long as its helping your symptoms and you're not having serious side effects. Otherwise, your provider might switch you to a different medication.
No, risperidone (Risperdal) isn't a controlled substance because it doesn't have a risk of addiction, misuse, or dependence.
Yes, it's possible to gain weight from taking risperidone (Risperdal). In studies, some people taking risperidone (Risperdal) gained at least 7% of their body weight before starting the medication. People who took higher doses of risperidone (Risperdal) experienced more weight gain. To lower your risk for weight gain while taking risperidone (Risperdal), make sure to have a healthy diet and regular exercise routine. Contact your provider if you're uncomfortable with how much weight you've gained while on risperidone (Risperdal). They might give you medications to treat the weight gain or switch you to a different medication.
Yes, sleepiness is one of the more common side effects of risperidone (Risperdal). But some people also experience other sleep problems while taking risperidone (Risperdal), including trouble falling asleep or vivid dreams. When you first start risperidone (Risperdal), pay attention to how this medication is affecting your sleep. If it's making you too sleepy or interrupting your sleep, contact your provider. They can try to ease the side effect by making changes to your dose or the timing of when you take this medication.
Stopping risperidone (Risperdal) too suddenly can cause withdrawal symptoms, such as nausea, vomiting, and dizziness. Make sure to take risperidone (Risperdal) exactly as prescribed. If you're interested in stopping the medication, contact your provider. They'll give you specific instructions on how to lower your dose slowly over a period of time before completely stopping the medication.

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