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Risperidone (Risperdal®)

Risperidone (Risperdal® and generic forms, Risperdal Consta®) belongs to a group of medications called “atypical antipsychotics” or “second-generation antipsychotics.”

What is this medication used for?

Risperidone was first developed to treat psychotic illnesses such as schizophrenia. Risperidone is not approved by Health Canada for use in children and adolescents.

However, research shows risperidone can help treat bipolar disorder, irritability of autism, tic disorders, delirium, disruptive behaviours and severe aggression.

When potential benefits outweigh risks, risperidone may be prescribed “off-label.” Learn more about off-label medication use:

Tell your doctor or pharmacist if you:

  • Have allergies or bad reactions to a medication
  • Take (or plan to take) other prescription or non-prescription medications, including natural medicines. Some medications interact with risperidone. Your doctor may adjust medication doses or monitor for side effects
  • Have a history (or family history) of kidney or liver disease, seizures, bowel obstruction, diabetes or glaucoma
  • Have a history (or family history) of heart disease, arrhythmia or “familial long QT syndrome”
  • Miss a period, are pregnant, breast-feeding or planning a pregnancy
  • Use alcohol or drugs. Taking risperidone together with certain substances may cause a bad reaction. Learn more at

When will the medication start to work?

Risperidone is usually prescribed to be taken regularly, but it is sometimes taken on an ‘as needed’ basis.

It may take about 1 to 2 weeks before the benefits of risperidone become noticeable. You (or your family members) may notice clearer thoughts, less moodiness, anger, irritability, tics or explosive behaviour.

It is important that you continue taking risperidone regularly even if you are feeling well, as it can prevent symptoms from returning. Talk with your doctor if you feel risperidone treatment has not been helpful. Your doctor may recommend switching you to a different medication.

This medication is not addictive. Do not stop taking it before talking to your doctor.

How do I take this medication?

Risperidone is usually taken once or twice a day, at the same time(s) each day. You may take risperidone with or without food. Usually, you will start with a low dose and slowly increase this dose over several days or weeks, based on how you tolerate it.

There are several forms of risperidone: tablets, liquid, and long-acting injection (Risperdal Consta®). Risperidone liquid can be mixed in water, orange juice, coffee or low-fat milk. Do not mix with tea or cola.

For the long-acting injection, a doctor or nurse will give this into a large muscle every second week. You may be asked to continue taking risperidone by mouth for a few weeks until the injections start to take effect.

Possible common or serious side effects:

Side effects may be more common when starting a medication or after a dose increase. Talk to your doctor, nurse or pharmacist if any side effect concerns you.

  • Dizziness, drowsiness, or headache
  • Feelings of agitation or restlessness
  • Stomach ache, constipation
  • Increased appetite or weight gain
  • Fast or irregular heartbeat
  • Muscle stiffness or muscle spasm
  • Increased blood glucose or cholesterol levels

Contact your doctor immediately if you experience:

  • Unexplained rash, seizure, fever or excessive sweating
  • Fainting, feeling lightheaded or difficulty with balance
  • Breast tenderness or swelling (males and females) or changes in menstrual cycle
  • Frequent urination accompanied by excessive thirst
  • Shaking, muscle spasm/stiffness, pain or weakness
  • Unusual movements of fingers, toes, neck, lips or tongue
  • Thoughts of hurting yourself, suicide, increased hostility or worsening symptoms

What precautions should my doctor and I be aware of when taking this medication?

  • When you take this medication, your body may have difficulty maintaining a normal body temperature. Drink enough fluids to avoid becoming dehydrated. Avoid doing a lot of physical activity on hot days.
  • While taking this medication, if you feel dizzy, drowsy or slowed down, do not drive a car or operate heavy machinery. Alcohol could make this worse. Try to avoid alcohol while taking risperidone.
  • Risperidone can cause a rare side effect called “tardive dyskinesia.” Symptoms include involuntary movements of the lips, tongue, toes, hands or neck. Stopping or switching this medication at first signs will decrease the chances this side effect will continue. These movements may become permanent without a medication change.
  • Risperidone can cause a rare side effect called “neuroleptic malignant syndrome.” Symptoms include severe muscle stiffness, high fever, sweating, increased or irregular heartbeat and increased blood pressure.

How do I store this medication?

Keep this medication in the original container, stored at room temperature away from moisture and heat and protected from light. Keep this medication out of reach and sight of children.

What special instructions should I follow while using this medication?

  • Keep all appointments with your doctor and the lab. Your doctor may order lab tests to check how you are responding and monitor for side effects.
  • Try to keep a healthy, well-balanced diet and exercise regularly. Some people may gain weight as a result of increased appetite.
  • Do not allow anyone else to use your medication.

What should I do if I forget to take a dose of this medication?

If you take risperidone regularly and forget to take a dose, take the missed dose as soon as you remember. However, if it is within 4 hours of your next scheduled dose, skip the missed dose and continue with your regular schedule. DO NOT double your next dose to try to ‘catch up’.

If you are receiving risperidone long-acting injections and you miss your dose, make an appointment with your doctor for injection administration.

How does this medication work?

Like other antipsychotics, risperidone affects actions of the brain chemicals dopamine and serotonin. The exact way that antipsychotic medications improve symptoms of schizophrenia, bipolar disorder and other conditions is not known.

How well does the medication work in children and adolescents?

Evidence supports the use of risperidone in children and adolescents. Risperidone has been shown to be better than placebo (an inactive pill) for treatment of schizophrenia in ages 15 and older, bipolar disorder in ages 10 and older, tic disorders including Tourette syndrome in ages 7 and older, and irritability associated with autism in ages 5 to 17. Risperidone also helps treat delirium and disruptive behaviour disorders in children.

How long should I take the medication for?

This depends on the symptoms you have, how frequently they occur, and how long you have had them. Most people will need to take risperidone for several months. This allows time for symptoms to stabilize and for function to improve. Your doctor will discuss the benefits and risks of taking risperidone with you. At this time, you can also discuss how long you might need to take this medication.

If you have schizophrenia and you tolerate risperidone well, you may be asked to take risperidone on an ongoing basis. Continuing treatment will significantly decrease the chance that your symptoms will return or that you will have symptoms return.

Do not increase, decrease, or stop taking this medication without discussing it with your doctor. If you stop taking risperidone suddenly, it is possible that your symptoms may return or you may have a bad reaction.

TIP: Use the Kelty Mental Health Antipsychotic Monitoring Form for Children and Adolescents to help measure your progress on this medication.

Also see the Kelty Mental Health document Atypical Antipsychotics & Metabolic Monitoring.

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