by Dr. Manura Nanayakkara

Created on: September 29, 2010

Risperidone is an atypical antipsychotic medication prescribed in schizophrenia, schizoaffective disorder, Autism in children and early phase of the bipolar mania. Most common brand name is Risperdal.

What is the mechanism of action?

Schizophrenia and other psychoses are caused by problems in brain chemistry. Risperidone alters and corrects the brain chemistry so patient’s psychotic features disappear. Risperidone blocks both dopamine and serotonin in certain brain regions. Dopamine block explains its effectiveness in schizophrenia and psychoses. Additional serotonin blockade counterbalances the dopamine effects in unwanted brain regions and prevents side effects.

What are the main indications?

1. Schizophrenia: - Schizophrenia is the most common condition Risperidone is prescribed for. Schizophrenia is characterized by positive symptoms such as delusions, hallucinations and negative symptoms like social withdrawal. Risperidone reduces positive symptoms as well as negative symptoms and allows the patient to function normally in the society. In addition, patients must take Risperidone for at least two weeks to feel a change. But the side effects will come before that and usually wanes after two to three weeks.

2. Schizoaffective disorder: - It is a disorder characterized by mixture of schizophrenic symptoms and manic depressive features. Usually patients have prominent mood symptoms.  

3. Bipolar disorder: - It is effective for the disturbances seen, especially in the manic phase of the bipolar disorder. This medication is effective, especially in the early manic phase where patients are disturbed. Additionally it has calming and sedating properties that will help disturbed patients. In addition, it is normally co - prescribed with other more effective mood stabilizer E.g. Lithium and Sodium valproate. After the initial phase of treatment, Risperidone is usually tailed off gradually because it does not have long term mood stabilization properties.

4. Other Psychoses: - It is also effective in psychoses other than the schizophrenia. These include acute psychotic episodes, alcoholic psychoses, cannabis psychosis and various other psychoses and delusional disorders.

5. Autism in children: - In addition, this medication is used in children with autism. It is a developmental disorder characterized by poor communication and impaired social interaction. Child psychiatrists prescribe this medication in Autism.

What the doctor should know before prescribing Risperidone?

If the patient has

* Drug allergies

* Depression

* Dementia

* Heart disease

* Seizure disorder

* Liver disease

* Kidney disease

* Stroke

* Parkinson’s disease

Then he/she must discuss with the doctor before taking this medication. In addition, the doctor should know whether the patient is pregnant or breast feeding. This medication should not be used in mothers, who are breast feeding their babies.

What are the common side effects?

Drowsiness and faintness are the commonest side effects. Gastrointestinal disturbances like nausea and vomiting are also common. In addition, some patients may get abnormal movements with this medication. Akathesia (inability to keep the feet in one place) is another troublesome side effect that can occur with Risperidone. In addition some women may complain abnormal milk production from their breasts.

Sources

BNF

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