Risperidone
Antipsychotic — atypical
Indications
SchizophreniaAcute maniaPersistent aggression in dementia (short-term, specialist)Conduct disorder
Adult dose
Schizophrenia: start 2 mg/day, target 4–6 mg, max 16 mg. Mania: 2–6 mg.
Paediatric dose
Conduct disorder (5–18 yrs, ≥50 kg): 0.5 mg OD, titrate to 1 mg, max 1.5 mg/day; specialist only.
Common side effects
EPS (dose-related)Hyperprolactinaemia (high)Weight gainSedationPostural hypotension
Serious side effects
NMSTardive dyskinesiaStroke risk in elderly with dementiaHyperprolactinaemia complications
Contraindications
Caution in cardiovascular disease, dementia (stroke)
Monitoring
- Metabolic panel as per antipsychotic monitoring
- Prolactin if symptomatic
- EPS (LUNSERS/SAS)
Notable interactions
- Carbamazepine lowers levels
- Fluoxetine/paroxetine raise levels
- Antihypertensives potentiated
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.