side effects, dosage, how to take & discontinue, uses, pros & cons, and more
Risperdal Article Index | Brand and Generic Availability ›
Learn More about Taking and Discontinuing Risperdal
Brand & Generic Names; Drug Class
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
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!
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
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.
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.
Risperdal’s Pros and Cons
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.
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
Don’t worry about buying one. Windows shop and share the designs you’d like to buy. Do you have something better to do right now?
Risperdal’s Potential 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
What You Really Need to be Careful About
Risperdal’s Black Box and Other Warnings, Pregnancy Category, etc.
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
As if I didn’t go on long enough already.
Ratings, Reviews, Comments, PI Sheet, and More
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.
Give your overall impression of Risperdal on a scale of 0 to 5.
Get all critical about Risperdal
Rating 2.6 out of 5 from 143 criticisms.
Vote Distribution: 49 – 5 – 11 – 10 – 30 – 38
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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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Pages and Forum Topics Google Thinks are Relevant to Your Mental Health
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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- Risperdal’s Full US Prescribing Information
- Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.
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 at least 72 hours. 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 (crazymeds.us)
|Last modified on Thursday, 26 June, 2014 at 09:56:28 by JerodPoore||Page Author Jerod Poore||Date created Tuesday, 08 March 2011 at 14:08:23|
|“Risperdal (risperidone): a Review for the Educated Consumer.” by Jerod Poore is copyright © 2011 Jerod Poore ||Published online 2011/03/08|
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Risperdal, and all other drug names on this page and used throughout the site, are a trademark of someone else. Risperdal’s PI Sheet 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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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.
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