Risperidone

Revision as of 15:51, 30 October 2017 by Jonwarren (talk | contribs) (Update to dosing, adverse effects, pharmacology)
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Administration

  • Type: Atypical antipsychotic
  • Dosage Forms: 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg; 1mg/mL
  • Routes of Administration: Oral, IM
  • Common Trade Names: Risperdal

Adult Dosing

Schizophrenia

  • <65 yo, 1st episode
    • 1-3 mg/day PO divided qd/bid
      • Max: 16mg/day
  • <65 yo, maintenance
    • 1-4 mg/day PO divided qd/bid
  • 65+ yo
    • 1-4 mg/day PO divided qd/bid
      • Doses >4 mg/day rarely more effective

Bipolar disorder, Type 1, Acute manic

  • 1-6 mg/day PO divided qd/bid
    • Max: 6 mg/day

Tourette Syndrome

  • 0.25-3 mg/day PO divided qd-bid
    • Max 6 mg/day

Pediatric Dosing

Pediatric procedural sedation

  • 0.01mg/kg/dose IM (typically 0.25-4mg/dose)

Schizophrenia

  • 1-6 mg/day PO divided qd/bid

Bipolar disorder, Type 1, Acute mania

  • 0.5-6mg/day PO divided qd/bid

Irritability, Autistic disorder associated

  • 0.5-3 mg/day PO divided qd/bid

Tourrette syndrome

  • 0.75-3 mg/day PO divided qd/bid

Special Populations

  • Pregnancy Rating: C
  • Lactation risk: Infant risk cannot be ruled out
  • Renal:
    • Adult:
      • CrCl <30: Start 0.5 mg BID then increase by 0.5mg BID weekly
      • HD: Not defined
    • Pediatric:
      • Not defined, see adult dosing.
  • Hepatic:
    • Adult:
      • Child-Pugh Class C: Start 0.5 mg BID and increase by 0.5mg BID weekly
    • Pediatric:
      • Not defined, see adult dosing.

Contraindications

  • Allergy to class/drug
  • Caution:
    • Pediatric/adolescent pts
    • Pregnancy 3rd trimester
    • Elderly pts
    • Dementia-related psychosis
    • Renal impairment
    • Hepatic impairment
    • Parkinson's Disease
    • Neuroleptic malignant syndrome history
    • Seizure history
    • Cardiovascular disease
    • Diabetes mellitus
    • Suicide risk

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 20h (PO); 3-6 day (IM)
  • Metabolism: Hepatic, CYP2D6
  • Excretion: Urine 70%, Feces 14%

Mechanism of Action

  • Unknown
  • 5HT-2 inhibitor, weaker D2 inhibitor

Comments

See Also

Antipsychotics

References