side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

> Risperdal (risperidone) Overview


Risperdal Article Index | Brand and Generic Availability

Brand & Generic Names; Drug Class

US brand name: Risperdal
Generic name: risperidone
Drug Class: Antipsychotics
Learn More about Risperdal’s Generic & Worldwide Availability
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Risperdal’s Approved & Off-Label Uses (Indications)

US FDA Approved Treatment(s)

Schizophrenia in adults & adolescents; Bipolar 1 in adults, children & adolescents

Popular Off-Label Uses

Augmenting SSRIs to treat OCD and/or major depression. Panic/Anxiety.

Learn More about Risperdal’s Approved & Off-label Uses

How Long Until Risperdal Starts Working (Onset of Action)

Like most antipsychotics you’ll feel something the next day. Within five to six days you should have a decent idea if Risperdal is going to do anything for you. You and your doctor may not be sure if it’s positive or not, but by then you should at least know if Risperdal may work. Various studies and trials have shown results in 2 to 7 days.

Likelihood of Working

Schizophrenia

The chances are pretty good that Risperdal (risperidone) will work for what can be ridiculously described as “basic,” “simple,” or even “normal” schizophrenia, schizoaffective and schizophreniform disorders. In equally simple terms, Risperdal is a simple drug. The same applies to Thorazine (chlorpromazine), Haldol (haloperidol), and Invega (AKA predigested Risperdal). If you’ve tried the broad-spectrum antipsychotics (Zyprexa (olanzapine), Seroquel, (quetiapine), Geodon/Zeldox (ziprasidone), Clozaril (clozapine) or Saphris (asenapine)), and they didn’t work - as in they weren’t effective, and not that their efficacy was overwhelmed by sucking so hard - Risperdal probably won’t either. Unless it was a question of maxing out the dosage, in which case Risperdal or some of the old-school drugs like fluphenazine. If Risperdal is the first med your doctor suggests, go for it!

Bipolar Disorder

The odds Risperdal (risperidone) will work for bipolar mania are pretty good as far as antipsychotics go. If you tend to get dysphoric manias and/or mixed states, where you want to smash everything in sight, instead of euphoric manias, Risperdal might become your best friend. Learn how Risperdal Compares with Other Drugs

How to Take Risperdal

Schizophrenia

For schizophrenia Ortho-McNeil-Janssen recommends starting at 2mg a day, increasing the dosage by 1–2mg a day until you reach 4mg a day. If needed, keep increasing the dosage until you reach 8mg a day. Once stable you can adjust your dosage as required with a range of 4–16mg a day.

Bipolar Disorder

For bipolar disorder Ortho-McNeil-Janssen recommends starting at 2–3mg a day, increasing the dosage by 1mg a day until you reach the target dosage of 1–6mg a day. Once stable you can adjust your dosage as required with a range of 1–6mg a day.

I don’t think I’m crazy enough to understand their math.
The dosages we suggest depend on how crazy you are at the time and if you’re already taking something. If you’re not too crazy and/or already taking something, try 0.25 - 0.5mg and increase by 0.25mg every 2–4 days. If very crazy, go with Janssen’s schedule. Especially if “very crazy” means the person who needs to take the Risperdal is not reading this because they are hospitalized.

How to Stop Taking Risperdal (Discontinue, Withdrawal)

Your doctor should be recommending that you reduce your dosage by 0.25 or 0.5mg a day every 4 to 5 days, if not more slowly than that. Like all antipsychotics, you can stop taking it all at once in an emergency situation (e.g. a life-threatening allergic reaction), but you should do that only under a doctor’s supervision.

Learn More about Taking and Discontinuing Risperdal

Risperdal’s Pros and Cons

Pros

Stops the rage induced by a dysphoric mania or mixed state like nothing else, in anywhere from an hour to the next day, without necessarily having to knock you out.

Other than the fact it’s working you can’t even tell you’re taking it for most applications.

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Cons

While its side effect profile is low at the low dosages, at the dosages required to treat the primary approved applications - schizophrenia and bipolar - it frequently does a number on your hormones. The rates for EPS & TD are higher than some standard antipsychotics.

Interesting Stuff your Doctor Probably didn’t Tell You about Risperdal

Risperdal is one of those drugs where the med you take isn’t the substance that does anything. Risperdal is metabolized by your liver to create the drug that actually does something, and that drug is available as Invega.

Best Known for

Leaky tits. Young or old, male or female, anyone taking Risperdal, especially more than 4mg a day, has a good chance of lactating.


In-Depth Pros & Cons

Risperdal’s Side Effects (Adverse Reactions)

Typical Side Effects

The usual: headache, nausea, dry mouth, constipation, sleepiness and lethargy or insomnia and way too much energy. Most everything of these go away within a couple of weeks, although the sleep & lethargy or insomnia & being wired may take a little longer.

Uncommon Side Effects

Loss of libido, other sexual dysfunctions, swollen breasts, unexpected lactation (it’s especially unexpected when it happens to guys) and all sorts of other stuff related to increased prolactin and other hormonal wackiness.
The AP-induced movement disorders, especially tardive dyskinesia (TD) and extrapyramidal symptoms (EPS). Risperdal is currently known as the worst AAP, and one of, if not the worst AP in general when it comes to movement disorders.
Those all seem to be dosage-related, so the higher the dosage the more likely / worse they’ll be.
Also heart palpitations, tachycardia and other cardiac weirdness

Freaky Rare Side Effects

Rabbit Syndrome. Duck syndrome! Rabbit syndrome! Duck syndrome! Sorry.
Plus discolored feces, and increased pigmentation.
Learn More about Risperdal’s Side Effects.
TMI at times

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What You Really Need to be Careful About

Having the highest rate of movement disorders such as TD & EPS of any atypical antipsychotic (although my money’s on Saphris eventually claiming that title).

Risperdal’s Black Box and Other Warnings, Pregnancy Category, etc.

Pharmacology

risperidone’s Half-Life & How Long Until It Clears Your System

Plasma half-life: Half-life: 21 hours clearance: 4–6 days

risperidone’s Pharmacokinetics Information Overload

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on risperidone’s pharmacokinetics page.

How risperidone Works

the current best guess at any rate
Risperdal is sort of like Haldol (haloperidol) on steroids, and is a potent antagonist of the the serotonin 5HT2A serotonin, D2 dopamine, alpha-1 and alpha-2a noradrenergic, and H1 histaminergic receptors. It is also a moderate antagonist for the 5HT1, 5HT5, and 5HT7 serotonin, and the alpha-2b and alpha-2c noradrenergic receptors. The broad swath of serotonin or norepinephrine action helps to explain why Risperdal is helpful for rage. The potent D2, along with 5HT2A and norepinephrine/noradrenergic blockades explain why Risperdal will give you porno boobs and make you shake like epileptic marionette.

Learn More than You Probably Ever Wanted to Know about How risperidone Works
AKA mechanism/method of action, pharmacodynamics

Ratings, Reviews, Comments, PI Sheet, and More

Risperdal Comments

I love Risperdal, and I miss taking it. I still keep some around for emergencies. And if worse came to worst, I’d take it again, TD be damned. I’d rather permanently look like an owl blinking Morse code, and whose tongue is sending out its own lewd messages, than deal with the crazy I went through in 2002.
Extended Comments
As if I didn’t go on long enough already.

Risperdal Ratings & Reviews, and Consumer Comments & Experiences

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Give your overall impression of Risperdal on a scale of 0 to 5. Detailed ratings and reviews are available on the Risperdal Ratings & Reviews Page.

Get all critical about Risperdal

3 stars Rating 2.7 out of 5 from 64 criticisms.
Vote Distribution: 14 – 5 – 8 – 5 – 14 – 18


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If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Risperdal (risperidone) Overview

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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.



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References

  1. Risperdal’s Full US Prescribing Information
  2. Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.

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Risperdal Article Index | Brand and Generic Availability

1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.

2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.


If you have any questions not answered here, please see the Crazymeds Risperdal discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher crazymeds.us


Last modified on Thursday, 26 June, 2014 at 09:56:28 by JerodPoorePage Author Date created Tuesday, 08 March 2011 at 14:08:23
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will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.




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