Though it was originally approved to treat psychosis, its use in children, including those with autism or ADHD diagnoses, has grown dramatically over the last two decades.
Without it, some would require residential treatment. Risperdal is what is called an atypical, or second-generation antipsychotic SGA. It was a new kind of antipsychotic approved by the Federal Drug Administration in the s to treat the symptoms of psychosis in schizophrenia and bipolar disorder.
Now it is more widely used to treat aggression and irritability in both dementia patients, often in inpatient facilities, and in children. Many kids on the autism spectrum take Risperdal to reduce behavior problems like aggression or self-injury, and the FDA has approved it for that use.
When kids act out dangerously or are at risk of getting kicked out of school or removed from the home, they may be given Risperdal or another SGA to calm them down. For kids who do not have an autism diagnosis, these prescriptions are off-label — that is, they are not an FDA-approved use for the drug. But a substantial body of evidence suggests they are effective in reducing persistent behavioral problems. Risperdal is controversial because side effects that include substantial weight gain and metabolic, neurological and hormonal changes that can be harmful.
Some experts are concerned that children are being treated with the drug in lieu of other treatment — including behavioral treatment — that could be effective without the risk of these side effects.
Risperdal has been in the news over the last several years because of thousands of lawsuits from families who say they were not informed about side effects that might adversely affect their kids, and the kids were not taken off the medication when problems developed. Many of the suits are on behalf of boys who, in a rare side effect, developed breasts because of an increase in a hormone called prolactin. This behavior often presents in early adolescence, says Dr.
Nash notes. Or the child might already have been sent to the emergency room after an outburst at school. Most experts, including Dr. Nash, stress the importance of thoroughly investigating the causes of aggressive behavior as part of the evaluation for medication. Behavior problems can have many different sources , including undiagnosed anxiety , ADHD , learning disorders , trauma and medical problems.
Treating those problems may allieviate the behavior issues in a more effective and lasting way than giving the child antipsychotic medication.
Depending on the level of risk, Dr. Nash says she might recommend a first trial of behavioral therapy, or medication together with behavioral therapy.
In a more stable situation, Dr. Nash also favors first trying more targeted medications with fewer side effects. If these attempts are not effective, Dr. Nash may try an SGA. Abilify aripiprazole , which is also approved for irritability in kids on the spectrum and commonly used for aggression, is usually her first choice, because it has fewer side effects, than Risperdal, including lower weight gain and endocrine disruption. But medication treatment should always be in combination with behavioral therapy, she stresses, which could include parent training.
The medical community agrees. A survey of treatment recommendations from top experts emphasizes that medication should not replace behavioral therapy. In Dr. The most common side effect of Risperdal is weight gain , which can occur quickly. In one study , average weight gain after In a study of children treated with Risperdal for 2. Only your healthcare provider can determine the correct dose for you. Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication.
You may also ask a family member or a friend to remind you or check in with you to be sure you are taking your medication. Risperidone orally disintegrating tablets must remain in their original packaging. Open the package with clean dry hands before each dose. Do not try to put tablets in a pillbox if you take the orally disintegrating tablets. Risperidone orally disintegrating tablets will dissolve in your mouth within seconds and can be swallowed with or without liquid. Risperidone liquid should be measured with a dosing spoon or oral syringe, which you can get from your pharmacy.
It should be administered by your health care professional through an injection into your upper arm or buttocks area. The medication effects last for approximately 2 weeks. It should be administered by your health care professional through an injection under the skin of your abdominal area.
After receiving the injection, you may have a lump for several weeks that will decrease in size over time. It is important that you not rub or massage the injection site and to be aware of the placement of any belts or clothing waistbands. If you miss a dose of risperidone, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Avoid drinking alcohol or using illegal drugs while you are taking risperidone. They may decrease the benefits e. If an overdose occurs call your doctor or You may need urgent medical care. You may also contact the poison control center at Sedation, drowsiness, extrapyramidal symptoms, insomnia, fatigue, headache, anxiety, dizziness, drooling, restlessness, increased prolactin, weight gain, increased appetite, vomiting, constipation, upper abdominal pain, nausea, urinary incontinence, tremor, cold symptoms, cough, runny nose, fever.
Risperidone may increase the blood levels of a hormone called prolactin. Side effects of increased prolactin levels include females losing their period, production of breast milk and males losing their sex drive or possibly experiencing erectile problems.
Long term months or years of elevated prolactin can lead to osteoporosis, or increased risk of bone fractures. Some people may develop muscle related side effects while taking risperidone. Symptoms of EPS include restlessness, tremor, and stiffness. TD symptoms include slow or jerky movements that one cannot control, often starting in the mouth with tongue rolling or chewing movements.
Temperature regulation: Impaired core body temperature regulation may occur; caution with strenuous exercise, heat exposure, and dehydration. Second generation antipsychotics SGAs increase the risk of weight gain, high blood sugar, and high cholesterol. This is also known as metabolic syndrome. Your healthcare provider may ask you for a blood sample to check your cholesterol, blood sugar, and hemoglobin A1c a measure of blood sugar over time while you take this medication.
Information on healthy eating and adding exercise to decrease your chances of developing metabolic syndrome may be found at the following sites:. SGAs have been linked with higher risk of death, strokes, and transient ischemic attacks TIAs in elderly people with behavior problems due to dementia. All antipsychotics have been associated with the risk of sudden cardiac death due to an arrhythmia irregular heartbeat.
To minimize this risk, antipsychotic medications should be used in the smallest effective dose when the benefits outweigh the risks. Your doctor may order an EKG to monitor for irregular heartbeat. Symptoms include confusion, fever, extreme muscle stiffness, and sweating. If any of these symptoms occur, contact your healthcare provider immediately.
All antipsychotics can cause sedation, dizziness, or orthostatic hypotension a drop in blood pressure when standing up from sitting or lying down. One long-term side effect can be putting on weight as taking risperidone can make you feel more hungry than usual.
If you're worried about long-term side effects then talk to your doctor. If you need to stop taking risperidone your doctor will help you reduce your dose so that you come off the medicine gradually.
If you and your doctor agree that you can stop taking risperidone suddenly then your symptoms may come back. You may also get withdrawal symptoms such as feeling or being sick, sweating and difficulty sleeping.
Talk to your doctor or your specialist if you have any problems when you reduce your dose or stop taking risperidone. It's best not to drink alcohol for the first few days of treatment until you see how the medicine affects you. If you drink alcohol while taking risperidone it may make you feel sleepy and unsteady on your feet. Drinking alcohol every day or in large amounts can make your symptoms worse.
It also makes it harder for risperidone to work properly. Risperidone can make you feel more hungry than usual, so you may put on weight. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you feel hungry between meals, eat fruit and vegetables and low-calorie foods. If you start to have problems with your weight while taking risperidone, talk to your doctor or pharmacist. Apart from limiting alcohol, you can eat and drink normally while taking risperidone.
If you have an increased appetite, try to eat a healthy balanced diet without increasing your portion sizes. Risperidone will not affect any type of contraception, including the combined pill or emergency contraception. However, if risperidone makes you sick vomit or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do. Find out what to do if you're on the pill and you're being sick or have diarrhoea.
Risperidone can affect your hormones and sometimes causes sexual problems in men or women. It can also affect periods. If you would like to start a family then talk to your doctor if you have any of these problems or if you are worried.
Risperidone can make you feel sleepy. If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel better.
Some people cannot concentrate properly while they are taking risperidone. When you first start taking risperidone, it's a good idea to stop driving and cycling for the first few days until you know how it makes you feel. It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking risperidone. UK has more information on the law on drugs and driving.
Page last reviewed: 25 August Next review due: 25 August Risperidone On this page About risperidone Key facts Who can and cannot take risperidone How and when to take risperidone Side effects How to cope with side effects of risperidone Pregnancy and breastfeeding Cautions with other medicines Common questions about risperidone. About risperidone Risperidone is medicine that helps with symptoms of some mental health conditions such as: schizophrenia where you may see, hear or feel things that are not there or you believe things that are not true or you feel unusually suspicious or have muddled thoughts mania symptoms of bipolar disorder , where your mood changes between feeling highly excited mania and very low depression aggressive or agitated behaviour in children over 5 years or young people with learning disabilities aggressive or agitated behaviour in adults with Alzheimer's disease It's an antipsychotic medicine.
Risperidone is only available on prescription. It can also be given as an injection for schizophrenia only. Risperidone works by affecting chemical messengers in the brain neurotransmitters like dopamine. It does not cure your condition but it helps to keep your symptoms under control. Risperidone does not work straight away. Common side effects include feeling sleepy, problems with your movement and headaches. It can make you feel more hungry than usual, so you may put on weight. Tell your doctor before starting the medicine if you: have ever had an allergic reaction to risperidone or any other medicine have a heart problem including arrhythmia have low blood pressure hypotension have had a stroke or are at high risk of having a stroke have ever had problems controlling the movements of your tongue, mouth and face have ever had a rare condition called neuroleptic malignant syndrome symptoms include a high temperature, muscle stiffness, sweating, anxiety and excess saliva have Parkinson's disease or dementia have ever had low levels of white blood cells have diabetes or epilepsy have ever had a prolonged or painful erection that lasted more than 2 hours have problems controlling your body temperature or overheating have kidney or liver problems have had a blood clot or someone in your family has had blood clots.
It's important to take risperidone as your doctor tells you. Dosage and strength How much you take will depend on what you're taking it for. Dose for schizophrenia under 65 years of age You'll usually start on a low dose of 2mg.
Dose for schizophrenia over 65 years of age You'll usually start on a low dose of 0. Dose for mania under 65 years of age You'll usually start on a low dose of 2mg once a day.
Dose for mania over 65 years of age You'll usually start on a low dose of 0. Dose for aggressive behaviour 18 years and older You'll usually start on a low dose of 0. Dose for aggressive behaviour in children 5 to 17 years Your child's dose will depend on their weight. How to take it Always follow the instructions in the leaflet that came with your medicine. You can take this medicine with or without food. How to take standard tablets Swallow your tablet with a drink of water.
How to take tablets that dissolve in your mouth dispersible Make sure your hands are dry. You can have a drink of water afterwards if you like. How to take liquid Your medicine will come with a syringe or dropper pipette to help you to measure out the right dose. Having risperidone injections Some people with schizophrenia may need to have risperidone as an injection.
What if I forget to take it? If you miss a dose and usually take risperidone: once a day — take the missed dose as soon as you remember unless it's less than 12 hours before the next dose is due.
In this case leave out the missed dose and take your next dose as usual twice a day — take the missed dose as soon as you remember unless it's less than 8 hours before the next dose is due. In this case leave out the missed dose and take your next dose as usual Do not take 2 doses at the same time to make up for a forgotten dose. What if I take too much? Taking too much risperidone can cause serious side effects such as: feeling sleepy or tired unusual body movements problems standing and walking feeling dizzy a fast heartbeat a seizure or fit.
Urgent advice: Contact for advice now if:. Common side effects These common side effects may affect up to 1 in 10 people.
0コメント