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What is risperidone?

Risperidone is a modern antipsychotic medication which is licensed for the treatment of schizophrenia and for the treatment of mania in bipolar disorder in adults.

What is risperidone used for in child psychiatry?

Risperidone is not licensed for use below the age of 18 years. Its use for under 18 year olds is based on the science of its use in adults. Its use is be divided into two main groups of children:

Psychotic disorders

This group includes childhood and teenagers with schizophrenia, mania in bipolar disorder, psychotic depression and other psychosis.

In these disorders, it helps to decrease or stop the main symptoms of distorted thinking and abnormal sensory perceptions.

Other disorders

Such as:

  • developmental disorders like autism and learning disabilities
  • movement disorders like tics and Tourette syndrome
  • attention deficit hyperactivity disorder (ADHD)

In these disorders, it helps to decrease:

  • excitation
  • agitation
  • aggression
  • tics
  • hyperactivity

Uncommon uses of risperidone include conduct disorder, eating disorders and obsessive compulsive disorder (OCD).

How does it work?

In some of the conditions mentioned above there is a chemical imbalance in the brain. Risperidone tries to fix this imbalance by changing the activity of some important messengers in the brain, like dopamine and serotonin. This has direct and indirect effects on both physical and mental functions in a person.

In what form is risperidone available?

  • Risperidol ® tablets in 0.5, 1mgs, 2mgs, 3mgs, 4mgs and 6mgs
  • Risperidol ® quicklets in 0.5mgs, 1mg and 2mgs
  • Risperidol ® liquid 1mg or ml
  • Risperidol consta injection in 25mgs and 50mgs as a depot preparation

Why is this medication prescribed?

Your doctor will explain the need for you to be on this medication and which symptoms should improve by taking it.

How well will this medication work?

About 4 in 5 people get help from this medication. It is important to note that it helps to control your symptoms but does not cure the disorder or illness.

What should my doctor check before starting this medication?

Your doctor will check if you suffer from any medical conditions especially diseases or conditions relating to:

  • your liver
  • your kidney
  • your heart
  • if you have epilepsy
  • if you or your family members have diabetes

You need to inform your doctor if you are on any regular medication like antiepileptic drugs or oral contraceptive medication.
Before starting the medication, your doctor may ask you to do some blood tests and an electrocardiogram. Your doctor will also record your height, weight, blood pressure and pulse.

What are its side effects?

Different people can get different side effects. The side effects can be eased by:

  • building up the dose slowly
  • decreasing the dose
  • changing to a different antipsychotic medication

Not everyone experiences major side effects. The most common side effects include:

  • headaches
  • poor or increased sleep
  • weight gain

Less commonly it can cause:

  • drowsiness
  • fatigue
  • dizziness
  • blurred vision

In some people, risperidone can cause:

  • unusual body movements like tremors
  • dystonia (spasms)
  • a feeling of restlessness called ‘akathisia’
  • reduce sexual desire
  • missed periods
  • breast enlargement (in both sexes)
  • increase your blood glucose levels and worsen any pre-existing diabetes

In rare instances, it can cause allergic reactions in the body.

How long will it take to act?

Some effects of risperidone are immediate yet others could take a few days or weeks to get going. It is important to carry on with this medication for a few weeks. If you feel it is not working, wait until a consultation with your doctor before you decide anything.

What is the right dose of this medication?

In children and teenagers, the dose range is from 0.25 to 8mgs. The dose depends on:

  • the condition it is prescribed for
  • the severity of the symptoms
  • the tolerance of side effects
  • whether or not you have a learning disability
  • age and rate of growth

It is safe to start on a minimal dose of 0.25mgs daily and build it up in small weekly increments until it feels effective. This helps handle side effects as well as making sure that you get the smallest dose which works for you.

How often is risperidone needed to be taken in the day?

Once the right dose is found it can be taken once or twice in a day in split doses. For example either 2mgs once per day, or 1mgs twice per day. Some people find it easier to take this medication once a day, but others find taking it in 2 half doses can help with side effects and symptom control.

What happens if a dose is missed?

Do not worry too much if you miss a single dose. If you are taking it once per day and miss the time you usually take it, you can take the dose when you remember. Then carry on taking your medication as normal. Try to not miss doses often or take the medication irregularly. Proper symptom control happens by taking the medication as prescribed by your doctor. If you miss taking the medication for 1 week or more, contact your doctor. You may need to start at a lower dose and slowly build it up again.

What if I take more than the prescribed dose?

If you take more than your prescribed dose, you should immediately contact your specialist or your GP.

Symptoms of overdose can range from:

  • excessive sleepiness
  • abnormal movements
  • low blood pressure
  • irregular heart rate

These symptoms will depend on how much risperidone you have taken, your medical fitness and other medications you may have taken. You may have to be taken to the Emergency Department to treat the overdose.

How long should this medication be taken for?

This will depend on the indication for which you are taking the medication. If you are taking it for a psychotic illness, you may have to take if for a long time. If you want to reduce or stop this medication, talk about it with your doctor.

What happens if this medication is stopped?

This depends on the condition for which you are prescribed this medication. If you have schizophrenia, the symptoms will usually come back, not immediately but often within 6 months.

How does this medication react with smoking and alcohol?

If you smoke, it is likely that you may need bigger doses of this medication to make it work. Alcohol could increase some side effects and worsen your symptoms.

What monitoring is needed for this medication?

Your specialist will continue to check your need to be on this medication and the side effects you are experiencing. Your weight, blood pressure and pulse rate will be monitored once a month. You will need blood tests at least once a year to monitor your blood sugar, your liver and kidney functions and a hormone level called prolactin.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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