As usual I'll be dealing only with adults.

Once again I strongly disagree with the standard dosing schedule.  By the book for both bipolar disorder and schizophrenia they would start you out at 2 to 3mg a day!  No matter how bad your symptoms are.  That's just crazy!  Risperdal (risperidone) is, milligram for milligram, the most potent antipsychotic on the market and they'd start you out half-way to the maintenance dosage for bipolar!

Now I'm reading study after study about schizophrenia, and improvement is seen when people start at 2mg a day within two days to a week.  So here's where you're going to have to decide what is sucking most.  If your symptoms are really harsh right now, then start at 2mg a day and get fast, fast relief.  Just be prepared to put up with the potential of harsh, if temporary, side effects.  That's really what it's all about, easing into the med, and putting off it's effect, or getting it to work right away.  You also increase the chances of EPS, and having to stop Risperdal and switching to another med.  Decisions, decisions.

So it's like this, if the ambassador from Zeta Reticula is visiting you every day with orders on how to start The Cleansing, and you're not taking any medications at all, then starting at 2mg a day is a Very Good Idea.

But if you're already on Depakote, your levels are good but you're just getting a bit hypomanic now and then, you should talk to your doctor about starting at 0.25 to 0.5mg a day.  Maybe it'll work in three days to a week, maybe you'll have to work up to a higher dosage.  Trust me, your liver will be happier if your brain isn't flipping out.

If you're a friend or family member reading this and your loved one is in a hospital and they've been started at 3mg a day, there's a reason for it.  They've been hospitalized!  Starting that high is going to suck, it's going to really suck, it's going to suck worse because they're in a hospital.  But all of that is going to suck much, much less than what could happen to them outside of the hospital setting.

But anyone who is together enough to not be in a hospital does not necessarily need to start Risperdal (risperidone) at 2mg a day.  That's all there is to it.  I think it's optional.

Hey, why the hell do you think they make the 0.25mg pills in the first place?  The pediatric market isn't that big.  So if you're not in a hospital and the next horsie to ride on the med-go-round is Risperdal (risperidone) ask about starting at 0.25 to 0.5mg a day and try to think about what a higher dosage means.

In any event, the clinical trials for Risperdal's approval, as well as numerous studies vs. other meds, are showing that 6mg a day is the optimal dosage for most people.  See the How Risperdal Works page for details.

Unless you're switching from another atypical antipsychotic that you've had to stop because of EPS or other nasty side effects.  In which case a rough guide to dosage conversion is as follows:

Risperdal (risperidone) - 0.5mg = Zyprexa (olanzapine) - 2.5mg = Abilify (aripiprazole) - 3mg = Geodon (ziprasidone) - 20mg = Seroquel (quetiapine) - 100mg

This guide works best at the lower dosages as given.  As these things aren't that linear, it doesn't map out that well at the higher dosages.  So if your doctor switches you from one to another and you jump from one mid-to-high dosage to some other mid-to-high dosage, the odds are it's going to be the correct dosage.

Sorry, I don't know the conversion of typical antipsychotics to atypicals.  I know you can do it, I just don't know the ratios.

So if you were on 400mg of Seroquel (quetiapine) then it would be OK to start taking 2mg of Risperdal (risperidone).  You'd probably skip some of the common side effects during the transition.

Anyway, if you're not switching from one antipsychotic to the other, and you're not really wigging out, there's no need to ramp up the Risperdal (risperidone) so quickly!  Start at 0.25 to 0.5mg a day and increase it by 0.25 to 0.5mg a day every week or two (depending on how often you see your doctor) until your symptoms go away, the side effects get too harsh, or you hit the maximum 6-8mg a day (out patient) or 16mg a day (in patient) dosage.

You can take Risperdal (risperidone) one to four times a day.  It looks like once a day works for bipolar and multiple doses work better for schizophrenia.

The dosages I could find for all of the off-label applications are really low.  Nothing was above 2mg a day and all started at 0.25mg a day.  I was taking 0.5mg a day and it was a huge help for both the autism and the bipolar.  As a poor metabolizer and in the autistic spectrum I define cheap date, so your mileage will vary on the dosage.

How Long Risperdal Takes to Work: Like all antipsychotics you'll feel something the next day.  By the time you reach a steady state, in five to six days, you'll know if this med is going to do anything for you.  Various studies and trials have shown results in 2 to 7 days.  See the How Risperdal Works page for details.  Most studies are showing effect after you reach 2mg a day, but that's when it's the only med you're taking.