How Long Does Risperidone Stay in Your System? • (2023)

August 24, 2021/ Erica Davies / General / 0 comments

Risperidone is an atypical antipsychotic that also comes as an oral tablet under the brand name Risperdal.

All medications that belong to a class of drugs known as atypical antipsychotics carry a black box warning from the FDA, aiming to warn people of the risks associated with the use of a certain drug.

In risperidone’s case, its manufacturer has so far paid billions of dollars already in Risperdal lawsuit settlements, not only for male breast development claims but also for claims that it illegally marketed the drug for off-label uses.

Below, you can read more about the most important details you should know about risperidone.

What is risperidone used for?

Risperidone is an antipsychotic medication that is mostly used to treat the symptoms of schizophrenia and other mood or mental disorders such as bipolar disorder.

It works in the brain by affecting various neurotransmitters, particularly dopamine and serotonin. These natural substances in the brain are mainly involved with mood, emotions, and behavior.

Schizophrenia, in particular, is associated with the excessive activity of dopamine in the brain. Risperidone rebalances dopamine and serotonin, leading to reduction and relief of symptoms.

(Video) Risperidone (Risperdal) A Comprehensive Review of an atypical antipsychotic medication

How long does it take to kick in?

Risperidone is a prescription drug that may come as an:

  • oral tablet
  • oral solution
  • orally disintegrating tablet
  • injection

Each person’s reaction to a certain medication is different. With that said, in some people, some effects may be observable within the first few days of use. However, for others, it may take up to three to six weeks for risperidone to work in full efficacy.

You should talk to your doctor about how it works for you over the first few weeks. If no positive changes are apparent after two to three weeks of use, your doctor may increase the dose or may consider changing your medication.

Typically, doctors start risperidone at a lower dose that will gradually increase to a certain dose that works for you. This will also depend on your response and tolerability to the medicine.

On the other hand, if you started with the long-acting injection, it may take at least three weeks before it starts releasing the risperidone. As such, your doctor may ask you to continue taking your tablets before the medication starts to kick in.

Your doctor will administer this injection every two weeks. The injection will also provide a steady release of risperidone over the same duration.

How long does it take for risperidone to wear off?

Slow-acting psych meds such as antipsychotics take 2-4 weeks to show positive effects and take longer for those effects to leave your system, which means that its benefits will not immediately go away as soon as the drug leaves your system.

Another important factor to consider is the half-life of risperidone. Most medications have a half-life of around 24 hours. But some may take 4-5 days to be completely flushed out of your system.

(Video) Risperdal Withdrawal, Risperidone Tapering Help, Side Effects & Alternatives | Alternative to Meds.

In the case of risperidone, studies show that its half-life for poor metabolizers is 20 hours, while for extensive metabolizers it may only take 3 hours for the chemicals from the medicine to leave the system.

However, you also have to consider other factors when looking at how long the antipsychotic drug will stay in your system. These factors include:

  • how long the drug was taken
  • the person’s metabolic function
  • health profile of the person
  • other drugs that were taken with risperidone
  • genetics
  • effects of other medications in use

With that said, it may take weeks or months for your brain to return to its original state after getting off this medication.

Can you just stop taking it?

In general, patients should refrain from stopping any medication without talking about it first with their healthcare provider. It’s also important to note that discontinuing the use of risperidone once you feel better is not a good idea. If you do this, you may experience some unpleasant side effects.

Some Risperdal withdrawal symptoms you might get include:

  • nausea (feeling sick)
  • dizziness
  • sleepiness
  • anxiety
  • vomiting
  • insomnia
  • return of symptoms of schizophrenia

Needless to say, discontinuing Risperdal cold turkey is not recommended, as it can cause the above-listed side effects.

With that said, if things get to the point where you feel like you want to stop taking the medication, it is important to maintain contact with your doctor. They can keep your withdrawal symptoms to a minimum by considering your medical history and current status.

Common side effects of risperidone

Some of the more common side effects of taking risperidone include:

(Video) Risperdal

  • anxiety
  • dizziness or low blood pressure
  • blurred vision
  • headache
  • fatigue
  • drooling
  • abdominal (gut) pain or discomfort
  • constipation
  • increase in a hormone called prolactin
  • restlessness
  • increased appetite or weight gain
  • heartburn
  • dry mouth
  • diarrhea

Serious side effects

Risperidone can potentially increase the blood levels of a hormone known as prolactin. The primary role of prolactin is to promote lactation or breast milk production.

High levels of prolactin may cause side effects, including:

  • milk discharge from the breasts
  • irregular or absent menstrual periods
  • erectile dysfunction
  • breast enlargement

In the Risperdal lawsuits, plaintiffs claim that taking the drug in hopes of treating their mental disorder symptoms instead led to gynecomastia or male breast development.

Aside from this side effect, however, risperidone can also potentially cause several other serious side effects, including:

  • extrapyramidal symptoms, which are drug-induced movement disorders that may include akathisia (restlessness), dystonia (muscle contractions and spasms), and parkinsonism (movement problems)
  • tardive dyskinesia (uncontrollable repetitive, jerking movements in your face, neck, and tongue)
  • orthostatic hypotension (a drop in blood pressure when standing up from a sitting or lying position)
  • high blood sugar and high cholesterol
  • difficulty swallowing
  • seizures
  • neuroleptic malignant syndrome (symptoms include fever, rigidity, and mental status change)

Disclaimer: This is not an all-inclusive list. You may experience possible side effects that are not mentioned above. This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Always talk to your healthcare provider about potential adverse effects and seek immediate medical attention if you experience serious side effects.

Risperidone has a black box warning

Risperdal got its FDA approval in 1994. It is recognized as a drug used to treat the symptoms of several mental health conditions, including:

  • schizophrenia
  • bipolar disorder
  • autism with irritability

But despite its known effectiveness for these psychological issues, the side effects associated with Risperdal can be life-changing and at times potentially life-threatening for people of different groups.

(Video) What is Risperidone?

As such, in 2005, the FDA issued a black box warning for Risperdal, which is the strictest warning given by the regulating agency that aims to warn consumers about serious or life-threatening side effects a certain drug may have.

The FDA black box warning on the Risperdal bottle states that the use of the antipsychotic medication is not approved in elderly patients due to the risk of death and stroke.

However, before the FDA gave this warning for the medication, risperidone was freely used in elderly patients with dementia-induced psychosis, even though the drug was not approved for use in older adults with dementia-related psychosis in the first place.

In fact:

Federal authorities found that the drugmaker Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson, marketed the drug for this use despite knowing its risks to elderly patients. As a result, J&J was made to pay $2.2 billion in criminal and civil fines after it pleaded guilty to illegally promoting the drug for use in older adults.

Risperdal and Gynecomastia

Even though it is recognized as an effective antipsychotic medicine, risperidone is linked to an increased risk of gynecomastia in young male patients. Researchers believe that it triggers a hormone imbalance in adolescent and young adult males that causes them to grow large breasts.

Gynecomastia is a condition where there is enlargement of the breast tissue in men or boys. Although this breast enlargement is non-cancerous, it can cause severe discomfort for someone who suffers from it, ranging from psychological distress to body image issues.

Some patients who even lactated due to this risk have filed Risperdal gynecomastia lawsuits and were later awarded punitive damages.

(Video) Withdrawal from Psych Drugs — UCLA Professor David Cohen, PhD

The Bottom Line

As with all medications, each person’s response may be different and the side effects one may experience could also vary.

Moreover, the information contained in this article does not cover all possible side effects one may have with risperidone. You should always consult your doctor before taking any medication and communicate any questions or concerns you have regarding the adverse effects of the medicine you are taking.


How long does risperidone last in your system? ›

It can take several days or even months for some symptoms to get better The half life of Risperidone is 20 hours, multiply by 5 would be when it is completely out of your system so 100 hours so basically in less than five days it would all be gone.

How long does 2mg of risperidone stay in your system? ›

How Long Does Risperdal Stay in Your System? Risperdal metabolites can be detected for between one and four days. The clearance time may have very little to do with withdrawal manifestations–there is a likelihood that receptors have upregulated themselves in response to the drug.

Does Risperdal build up in your system? ›

Risperidone may make these conditions worse. For people with kidney problems: If you have moderate to severe kidney disease, you may not be able to clear this drug from your body well. This may cause risperidone to build up in your body. This can lead to more side effects.

Can you just come off risperidone? ›

Talk to your doctor if you want to stop taking risperidone. If you need to stop taking risperidone your doctor will help you reduce your dose so that you come off the medicine gradually. If you and your doctor agree that you can stop taking risperidone suddenly then your symptoms may come back.

Can you fail a drug test for risperidone? ›

Antipsychotic drugs

Chlorpromazine, which is used to treat manic depression and schizophrenia can wrongly show up as amphetamine. Risperidone and Haloperidol have also been found to show up as false LSD results.

What happens to your body when you stop taking risperidone? ›

Risperidone is not addictive, but stopping it suddenly can cause problems such as difficulty sleeping, feeling or being sick, sweating, and uncontrollable muscle movements. See you doctor if you want to stop, or if you are having these effects.

What is the peak time for risperidone? ›

Following oral administration of solution or tablet, mean peak plasma concentrations of risperidone occurred at about 1 hour. Peak concentrations of 9-hydroxyrisperidone occurred at about 3 hours in extensive metabolizers, and 17 hours in poor metabolizers.

Is .5 mg of risperidone a lot? ›

The effective dose range is 0.5 to 3 mg per day. This drug may be administered orally once a day or in divided doses twice a day; patients experiencing somnolence may benefit from twice a day dosing.

What is the half life of Risperdal? ›

Hydroxylation of risperidone is subject to the same genetic polymorphism as debrisoquine and dextromethorphan. In poor metabolizers the half-life of risperidone was about 19 hours compared with about 3 hours in extensive metabolizers.

Are risperidone side effects permanent? ›

However, most of the common side effects will improve when the medication is discontinued. Some, like neuroleptic malignant syndrome, may require treatment to get better. Unfortunately, many risperidone side effects may be long-term or lifelong conditions such as tardive dyskinesia and diabetes.

Does risperidone cause permanent changes? ›

But unfortunately, it can also be permanent. Metabolic changes. High blood sugar, abnormal cholesterol levels, and weight gain can occur with risperidone. These metabolic changes may raise your risk of having a heart attack, blood clot, or stroke.

What can you take instead of risperidone? ›

Risperidone belongs to a class of medications called atypical antipsychotics, also known as second-generation antipsychotics.
Top 5 risperidone alternatives
  • Abilify (aripiprazole) ...
  • Haloperidol. ...
  • Zyprexa (olanzapine) ...
  • Seroquel (quetiapine) ...
  • Invega (paliperidone)
Jul 12, 2022

Is risperidone a high risk medication? ›

Warnings: There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems.

Can you take risperidone forever? ›

Risperidone may be used long-term; however, a doctor should periodically reevaluate its effectiveness and monitor you for side effects.

What are the long-term side effects of risperidone? ›

The biggest disadvantages of Risperdal are the potential long-term side effects, which can include tardive dyskinesia, increased blood sugar, high triglycerides, and weight gain.
Common side effects of Risperdal can include:
  • Weight gain.
  • Restlessness.
  • Agitation.
  • Dry mouth.
  • Increased saliva.
  • Nausea.
  • Vomiting.
  • Diarrhea.
Sep 21, 2022

Is there a class action lawsuit against risperidone? ›

There is not currently an active class action lawsuit against Risperdal at this time.

Can risperidone cause a false positive drug test? ›

Of the SGAs, risperidone has been reported to cause false-positive LSD results;3,9 quetiapine, false-positive methadone and TCA results, which are attributed to quetiapine's resemblance in structure to methadone and TCAs.

What is the success rate of risperidone? ›

Weight gain was the most common side effect in both groups, followed by somnolence. Somnolence was the most robust predictor of nonsuccess. In our clinic-referred sample, the short-term success rate of risperidone was more than 50%, and side effects limited its use.

How long does it take to wean off Risperdal? ›

How long is my Risperdal taper going to last? At Alternative to Meds, we have observed that in general, a good starting point would be one month of tapering for every year a person has been on antipsychotic medication.

How long does it take to feel normal after stopping antipsychotics? ›

The studies in our review (8, 23–26) reported that most withdrawal symptoms started within 4 weeks after abrupt antipsychotic discontinuation and subsided after up to 4 weeks even though certain symptoms such as hyperkinesia may last for months (23).

What is the highest milligram of Risperdal? ›

The initial dose range is 2 mg to 3 mg per day. The dose may be adjusted at intervals of 24 hours or greater, in increments of 1 mg per day. The effective dose range is 1 mg to 6 mg per day, as studied in the short-term, placebo-controlled trials.

Can you take risperidone every other day? ›

Participants taking olanzapine or risperidone will be switched to an alternate day dosing schedule. Participants will continue to take their olanzapine or risperidone following the same prescribed daily schedule.

Is 1 mg of Risperdal a lot? ›

The optimum dose is 1 mg once daily for most patients. Some patients, however, may benefit from 0.5 mg once daily while others may require 1.5 mg once daily. For subjects <50 kg, a starting dose of 0.25 mg once daily is recommended.

What does risperidone do to the brain? ›

Risperidone works by blocking the receptors in the brain that dopamine acts on. This prevents the excessive activity of dopamine and helps to control schizophrenia.

What is the difference between risperidone and risperidone? ›

Risperdal (risperidone) is an atypical antipsychotic drug often prescribed for treating schizophrenia, psychotic episodes of bipolar disorder, and other mental illnesses. Risperdal and risperidone are two names for the same medication; Risperdal is the brand name and risperidone is the generic name.

What is the safest anti psychotic? ›

Clozapine and olanzapine have the safest therapeutic effect, while the side effect of neutropenia must be controlled by 3 weekly blood controls.

What mental illness is risperidone for? ›

Risperidone is used to treat schizophrenia, bipolar disorder, or irritability associated with autistic disorder.

Is risperidone long acting? ›

Summary: Risperidone is the first atypical antipsychotic available in a long-acting injectable formulation. After a single injection, significant plasma levels of the drug are achieved at week 3 and sustained through week 6, subsiding by weeks 7-8.

How far apart should risperidone be taken? ›

It is usually taken once or twice a day with or without food. Take risperidone at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Can Risperdal cause permanent damage? ›

Risperdal can also cause movement disorders that worsen over time. The disorders may be permanent, even after the person stops taking Risperdal.

What are the long term side effects of risperidone? ›

The biggest disadvantages of Risperdal are the potential long-term side effects, which can include tardive dyskinesia, increased blood sugar, high triglycerides, and weight gain.
Common side effects of Risperdal can include:
  • Weight gain.
  • Restlessness.
  • Agitation.
  • Dry mouth.
  • Increased saliva.
  • Nausea.
  • Vomiting.
  • Diarrhea.
Sep 21, 2022

What are the warnings for risperidone? ›

Check with your doctor right away if you or your child have any of the following symptoms while using this medicine: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, ...

How long does it take to wean off risperidone? ›

In general, wean gradually by 25% of the daily dose every 1-4 weeks. If reason for deprescribing is due to serious adverse effects, consider weaning faster. Provide advice to patient/carer on self-monitoring and what to do if symptoms re-occur.

Does risperidone change the brain? ›

In patients with schizophrenia, sustained treatment with risperidone produced a decrease in activity in the medial frontal cortex that is correlated with a decrease in the severity of positive symptoms.


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