Medically reviewed by Carmen Fookes, BPharm. Last updated on Aug 17, 2022.
1. How it works
- Risperidone may be used to treat psychotic symptoms, schizophrenia, bipolar I disorder, or to relieve symptoms of autistic disorder in children.
- Experts are not sure exactly how risperidone works but suggest that its main effects are the result of it blocking both dopamine and serotonin receptors. Other effects may be due to blocking other neurotransmitter receptors.
- Risperidone belongs to the class of medicines called atypical antipsychotics. Atypical means it is less likely than older antipsychotics to cause extrapyramidal side effects.
- Relieves psychotic symptoms such as hallucinations, delusions, confusion, disturbed thoughts, and lack of insight or self-awareness.
- Used either alone or in combination with other medicines for the treatment of schizophrenia, acute mania, or mixed episodes in bipolar disorder.
- May be used in addition to lithium or valproate when used for acute manic or mixed episodes associated with Bipolar I disorder.
- Risperidone in small dosages may be also used to relieve irritability and symptoms of aggression, temper tantrums, and mood fluctuations in children and adolescents aged 5 to 17 years with autistic disorder.
- Not a controlled substance.
- Generic risperidone is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Drowsiness that may affect your ability to drive or operate machinery. Avoid alcohol.
- Extrapyramidal symptoms (such as restlessness, tremor, uncontrolled muscle contractions) are more likely at dosages greater than 6mg/day. Higher dosages have also not been associated with extra efficacy. Dosages for adolescents should be limited to 3mg/day to limit the risk of side effects.
- Other common side effects include anxiety, blurred vision, dizziness, gastrointestinal disturbances (nausea, vomiting, constipation, diarrhea, dyspepsia, pain), excessive salivation, tiredness, weight gain, and rash. Uncommonly, a reduction in the numbers of white blood cells, swallowing difficulty, priapism (sustained erections), and seizures may occur.
- A drop in blood pressure on standing, particularly during the initial dose-titration period; dosage may need to be reduced then titrated up slowly. May not be suitable for people with known cardiovascular disease (history of a heart attack, angina, heart failure, or arrhythmia), stroke, and people at risk of dehydration.
- An increase in blood sugar levels. People with a history of diabetes or at risk of diabetes should be monitored closely. May also cause undesirable changes in blood cholesterol and lipid levels and weight gain (on average, 4.3kg after 6 months of therapy).
- An increase in prolactin levels (risk is higher than with most other antipsychotics), leading to side effects such as impaired fertility, an absence of menstruation, unwanted lactation, breast enlargement in men, impotence, and decreased bone density. May not be suitable for people with a history of prolactin-dependent breast cancer.
- Potentially irreversible tardive dyskinesia, even with low dosages that have only been taken for a short period. Symptoms include facial grimacing, repetitive chewing, and tongue thrusting.
- May interact with some medicines. Dosage may need increasing when used with enzyme inducers such as carbamazepine or phenytoin; dosage may need reducing when used with enzyme inhibitors such as fluoxetine or paroxetine. See the prescribing information for risperidone for the full list of interactions.
- Should not be used for the treatment of dementia-related psychosis in elderly people because risperidone has been associated with a higher risk of death.
- Rarely, may cause Neuroleptic Malignant Syndrome; symptoms include high body temperature, muscle rigidity, and mental disturbances; discontinue immediately and seek urgent medical advice.
- There are no controlled studies investigating the use of risperidone in pregnant women. Neonates exposed to antispsychotic agents, such as risperidone, in the third trimester are at risk for extrapyramidal or withdrawal symptoms following delivery. Only use in pregnancy if the potential benefits justify the risk. Risperidone and its metabolites are present in breast milk, and breastfeeding while taking risperidone is not recommended.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Bottom Line
- Risperidone is an antipsychotic that relieves psychotic symptoms in people with schizophrenia or mania and is also used in the treatment of autistic disorder. Side effects are less likely at lower dosages and risperidone should not be used for the treatment of people with dementia-related psychosis.
- Risperidone should be started at a lower dose initially then gradually titrated up depending on an individual's response and tolerability. Follow your doctor's instructions.
- Some people are more sensitive to the effects of risperidone and may need a more gradual increase in dosage - talk with your doctor if you are having trouble tolerating any side effects of risperidone.
- Splitting the daily dose into a morning and evening dose may help reduce symptoms of drowsiness in people with persistent drowsiness.
- Risperidone may cause drowsiness and you should not drive or operate machinery if risperidone has this effect on you. Avoid alcohol as it may potentiate the sedative effect of risperidone.
- Risperidone may be used long-term; however, a doctor should periodically reevaluate its effectiveness and monitor you for side effects. When used to delay relapse in people with schizophrenia, effectiveness in trials has lasted for at least 2 years (the duration of the trial).
- Risperidone may make you feel dizzy when going from a sitting or lying down position to standing. This may increase your risk of falls. Stand up slowly and remove any fall hazards from your home (such as loose rugs).
- Talk with your doctor if you develop any worrying side effects such as uncontrollable facial grimacing, restlessness, severe dizziness, or severe abdominal discomfort.
- Tell your doctor if you are intending to become pregnant and you are taking risperidone because your doctor may wish to change you to a different medication before you fall pregnant. Risperidone is incompatible with breastfeeding.
6. Response and effectiveness
- Some effects may be noticed within a few days but it may take up to three to four weeks for the full effects of risperidone to be seen.
- Risperidone is metabolized to an active metabolite, 9-hydroxy-risperidone.
- Risperidone orally disintegrating tablets, risperidone oral solution, and risperidone tablets are all bioequivalent (this means that there is no difference in the extent to which they are absorbed and their effect).
Medicines that interact with risperidone may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with risperidone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with risperidone include:
- antidepressants such as citalopram, escitalopram, or fluoxetine
- antipsychotics such as aripiprazole, clozapine or haloperidol
- CYP2D6 inhibitors or inducers, such as fluoxetine
- CYP3A4 inducers, such as carbamazepine, oxcarbazepine, phenytoin, rifampin, St John's Wort
- CYP3A4 inhibitors, such as clarithromycin, cyclosporine, fluconazole, ketoconazole, nefazodone, ritonavir, tamoxifen, verapamil
- diuretics, such as furosemide or hydrochlorothiazide
- heart medications, such as amlodipine, betaxolol, candesartan, carisprodol
- HIV medications, such as indinavir, nelfinavir, ritonavir, and saquinavir
- ipratropium or tiotropium
- kava kava
- magnesium sulfate
- medications used to treat Parkinson's Disease, such as cabergoline and levodopa
- opioids, such as alfentanil, fentanyl, buprenorphine, methadone, or oxycodone
- potassium chloride
- QT-prolonging medications, such as amiodarone, clarithromycin, domperidone, flupentixol, sotalol or voriconazole
Avoid drinking alcohol or taking illegal or recreational drugs while taking risperidone.
Note that this list is not all-inclusive and includes only common medications that may interact with risperidone. You should refer to the prescribing information for risperidone for a complete list of interactions.
More about risperidone
- Check interactions
- Compare alternatives
- Reviews (694)
- Drug images
- Side effects
- Dosage information
- During pregnancy
- Support group
- Drug class: atypical antipsychotics
- Drug Information
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- Risperidone Tablets
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- Prescribing Information
Related treatment guides
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- Risperidone. Revised 01/2022. AvKARE. https://www.drugs.com/pro/risperidone.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use risperidone only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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What happens if a normal person takes risperidone? ›
Risperidone oral tablet may cause drowsiness and the feeling of being unstable. This may lead to falling, which can cause broken bones or other health problems. You may be at a higher risk for falls if you're an adult who's over age 65 years and taking other medications that cause drowsiness.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 is the most common side effect of risperidone? ›
The bottom line
Common risperidone side effects include nausea, constipation, and dry mouth. More serious side effects include movement problems, hyperprolactinemia, and a greater risk of falls.
This medicine may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.How long can you safely take risperidone? ›
If you take risperidone for bipolar disorder or schizophrenia, you should think about taking it for a few years, otherwise your old symptoms can come back. Young people taking risperidone for conduct disorders will usually only take it for six weeks.Can you take Risperdal for life? ›
Yes, many people take risperidone for a long time. Risperidone treats your condition but it will not cure it. It helps to keep your symptoms under control. One long-term side effect can be putting on weight as taking risperidone can make you feel more hungry than usual.Is it hard to get off risperidone? ›
Risperdal (risperidone) withdrawal can be challenging. Professional guidance and help can be hard to find. And, you may feel it is the drug itself that is the major part of the problem. Atypical antipsychotic medications are generally prescribed in a crisis situation.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.Is there a lawsuit against Risperdal? ›
Settlement Amounts for Risperdal Lawsuits
Johnson & Johnson settled most cases with $800 million in legal expenses, part of which is the amount paid as settlement.
Risperidone is used to treat schizophrenia, bipolar disorder, or irritability associated with autistic disorder.
What foods to avoid with Risperdal? ›
RisperiDONE oral solution should not be mixed with tea or cola. It may be taken with water, coffee, orange juice, or low-fat milk. You should avoid the use of alcohol while being treated with risperiDONE.
Risperidone is a medication taken by mouth, widely used for treating people manage the symptoms of psychosis. As well as being an antipsychotic (preventing psychosis), it also could calm people down or help them to sleep.Does risperidone affect thinking? ›
Risperidone will impair performance in tasks assessing spatial memory and some executive functions in adolescents with ADHD and DBDs.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 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 many hours does Risperdal last? ›
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.Does Risperdal help with anxiety? ›
Risperdal (risperidone) and Xanax (alprazolam) are used to treat anxiety. Risperdal is used off-label in the treatment of anxiety. Risperdal is typically prescribed to treat schizophrenia, bipolar mania, and autism.Does risperidone make you unhappy? ›
agitation, anxiety, restless feeling; depressed mood; dry mouth, upset stomach, diarrhea, constipation; weight gain; or.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.What drug is better than risperidone? ›
Abilify, Haloperidol, Zyprexa, Seroquel, and Invega are some risperidone alternatives.
What are the negative effects of Risperdal? ›
Drowsiness, dizziness, lightheadedness, drooling, nausea, weight gain, or tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Dizziness and lightheadedness can increase the risk of falling.What can I replace Risperdal with? ›
Medications that are prescribed by traditional medical professionals as alternatives to Risperdal include other atypical antipsychotics such as clozapine or Clozaril, and typical (first-generation) antipsychotics such as haloperidol or Haldol.Why was Risperdal taken off the market? ›
The drug was only approved to treat schizophrenia in adults. April 2005 – A Black Box Warning was added to the drug's label after the FDA learned that the use of the drug among elderly patients with dementia could heighten the possibility of death.Can risperidone improve thinking? ›
Use of long-acting injectable risperidone seemed to be associated with improved performance in the domains of attention/vigilance, verbal learning and memory, and reasoning and problem solving, as well as psychomotor functioning.Can you have caffeine with Risperdal? ›
Tests indicate that RISPERDAL oral solution is compatible in the following beverages: water, coffee, orange juice, and low-fat milk; it is NOT compatible with either cola or tea.How does caffeine affect risperidone? ›
Thus, smoking or caffeine intake should not influence dosing of aripiprazole (Abilify) and risperidone (Risperdal) (the metabolism of both depends on CYP2D6 and CYP3A4) (Prior and Baker, 2003; Swainston Harrison and Perry, 2004), quetiapine (Seroquel) (mainly metabolized by CYP3A4), and ziprasidone (Geodon) (mainly ...Does Risperdal affect the heart? ›
Numerous studies show Risperdal and other atypical antipsychotic drugs can interfere with the electrical impulses that regulate heart rhythm, causing cardiac arrhythmias that can lead to cardiac arrest and death.Does risperidone help with obsessive thoughts? ›
Open-label reports and one controlled study suggest that risperidone addition is effective in patients with obsessive compulsive disorder (OCD) refractory to treatment with serotonin reuptake inhibitors . However, risperidone has also been implicated in the production or exacerbation of OCD symptoms [2, 3].Can risperidone cause obsessive thoughts? ›
Dr. Alevizos et al 1 in a recent article highlight that higher doses of risperidone are associated with emergence of obsessive compulsive (OC) symptoms while lower doses are used as augmentation in serotonin reuptake inhibitor refractory obsessive compulsive disorder.What happens if you take antipsychotics if you don t need them? ›
They can cause movement disorders such as twitching and restlessness, sedation and weight gain, and lead to diabetes.
Is risperidone a happy pill? ›
It is also known as a second-generation antipsychotic (SGA) or atypical antipsychotic. Risperidone rebalances dopamine and serotonin to improve thinking, mood, and behavior.Can risperidone hurt you? ›
This medicine may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.Does risperidone calm you down? ›
Risperidone is a medication taken by mouth, widely used for treating people manage the symptoms of psychosis. As well as being an antipsychotic (preventing psychosis), it also could calm people down or help them to sleep.Will I be on antipsychotics forever? ›
Some people need to keep taking it long term. If you have only had one psychotic episode and you have recovered well, you would normally need to continue treatment for 1–2 years after recovery. If you have another psychotic episode, you may need to take antipsychotic medication for longer, up to 5 years.Do people stay on antipsychotics for life? ›
Antipsychotics are often recommended life-long for people diagnosed with schizophrenia or other serious mental illnesses because they are effective at controlling psychotic symptoms in the short term and might reduce the risk of relapse.Can you ever get off antipsychotics? ›
Some people may be able to stop taking antipsychotics without problems, but others can find it very difficult. If you have been taking them for some time, it can be more difficult to come off them. This is especially if you have been taking them for one year or longer.How many hours does risperidone last? ›
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.Is risperidone a powerful drug? ›
Risperdal (risperidone) is a powerful second generation antipsychotic initially approved for the treatment of schizophrenia in adults and adolescents.Is there a class action lawsuit against risperidone? ›
There is not currently an active class action lawsuit against Risperdal at this time.