Risperidone

Risperidone (ris PER i done) is a generic medication prescribed for certain mental health conditions, including schizophrenia. Risperidone belongs to a group of drugs called atypical antipsychotics.

Introduction

Written by Alex Brewer, PharmD, MBA
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP
Updated on May 30, 2023

Introduction

Specifically, the Food and Drug Administration (FDA) has approved risperidone to treat:

• irritability due to autism in some children
• schizophrenia in adults and some children
• manic or mixed episodes of bipolar I disorder in adults and some children

This article describes risperidone’s uses, side effects, and more. Below you’ll also find some coupon options to help save on the cost of risperidone.

This article doesn’t provide coupons for all forms of risperidone. To find coupons for risperidone orally disintegrating tablet, see this article.

Boxed warning: Increased risk of death in certain older adults

Risperidone has a boxed warning about an increased risk of death in certain older adults. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for risperidone” section.

Side effects of risperidone

Risperidone may cause mild or serious side effects (also known as adverse effects). More common mild side effects of risperidone and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about risperidone’s side effects, talk with your doctor or pharmacist. You can also read the prescribing information* for risperidone.

* To view risperidone’s prescribing information, see the “Article resources” section.

Mild side effects

More common mild side effects reported with some forms of risperidone are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about risperidone’s side effects based on the form, see the prescribing information* for risperidone.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Risperidone oral tablet’s and oral solution’s mild side effects include:

• sleepiness or drowsiness
• dizziness
• tremors
• nausea and vomiting
• mild allergic reaction†

* To view risperidone’s prescribing information, see the “Article resources” section.
† For details about this side effect, see the “Interactions and warnings for risperidone” section.

Serious side effects

Serious side effects of risperidone are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about risperidone’s side effects, see the prescribing information* for risperidone.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, risperidone’s serious side effects include:

• blood cell problems, including low white blood cell count
• trouble swallowing, which may lead to aspiration (fluid or food entering the lungs)
• high levels of the hormone prolactin, which can lead to symptoms such as erectile dysfunction and missed periods
• problems with motor skills, thinking, or ability to perform tasks such as driving and operating machinery
• metabolic problems, including weight gain, high cholesterol, and type 2 diabetes
• neuroleptic malignant syndrome (a rare but serious reaction to certain medications)
• low blood pressure when standing or sitting up, which can lead to falls
• priapism (a long lasting erection that doesn’t go away and may damage the penis)
• problems with the body’s ability to regulate body temperature
• tardive dyskinesia (a condition that causes uncontrolled movements, such as twitches)
• boxed warning: increased risk of death in certain older adults†
• severe allergic reaction,† including severe skin reactions

* To view risperidone’s prescribing information, see the “Article resources” section.
† For details about this side effect, see the “Interactions and warnings for risperidone” section.

Uses of risperidone

The Food and Drug Administration (FDA) approves prescription drugs such as risperidone for certain conditions. Approved uses for risperidone are described below.

Use for irritability due to autism

Doctors may prescribe risperidone oral tablet, orally disintegrating tablet, and oral solution for treating irritability due to autism spectrum disorder. The drug is prescribed for this purpose in children ages 5 years and older. It may be prescribed as a short-term or long-term treatment.

Autism spectrum disorder is a developmental condition. It may affect how people interact or communicate with others. Some people have irritability as a symptom, too. This can cause mood changes, outbursts, and aggression or hostility towards others.

Use for schizophrenia

Doctors may prescribe risperidone oral tablet, orally disintegrating tablet, and oral solution for treating schizophrenia. It’s prescribed for this purpose in people ages 13 years and older. It may be prescribed as a short-term or long-term treatment.

Schizophrenia is a long lasting mental health condition. It causes changes in your perception of reality. Symptoms may include:

• Hallucinations. These are experiences that aren’t real but are created by the mind. Examples include hearing voices or seeing things that aren’t really there.
• Delusions. These are beliefs that are held even though facts and evidence contradict them.

Other symptoms of schizophrenia include paranoia, trouble doing everyday activities or experiencing pleasure, and others.

Use for bipolar disorder

Doctors may prescribe risperidone oral tablet, orally disintegrating tablet, and oral solution for treating manic or mixed episodes of bipolar I disorder. It’s prescribed for this purpose in people ages 10 years and older. It may be prescribed as a short-term or long-term treatment.

Bipolar disorder is a mental health condition that causes large shifts in mood. It may be diagnosed as either bipolar I or bipolar II.

Risperidone is prescribed to treat manic or mixed episodes caused by bipolar I disorder. People with bipolar I disorder have episodes of mania and episodes of depression. For reference:

• Mania refers to a highly elevated mood. Symptoms include feeling excited, acting impulsively, and having high energy levels.
• Depression refers to a low mood. Symptoms include losing interest in activities you usually enjoy, feeling hopeless or worthless, and having trouble doing everyday tasks.

Some people with bipolar I disorder have symptoms of both mania and depression. This is known as a mixed episode.

Common questions about risperidone

Below you’ll find answers to a few commonly asked questions about risperidone.

How does risperidone work? And how long does it take to start working?

How risperidone works isn’t fully understood. It’s thought to affect certain chemicals in the brain to help treat certain mental health conditions.

Risperidone begins working after you take a dose. However, it may take several weeks before you notice your symptoms are reduced. Talk with your doctor to learn how they’ll monitor how well risperidone works for you.

Can risperidone be taken for anxiety, ADHD, or sleep?

It’s possible. But risperidone isn’t approved to treat the following conditions:

• anxiety
• attention deficit hyperactivity disorder (ADHD)
• problems with sleep

However, doctors may prescribe the drug off-label for these or other uses. With off-label use, a drug is prescribed to treat a condition that it isn’t approved to treat.

Talk with your doctor if you’d like to learn more about possible off-label uses of risperidone. You can also talk with your doctor about medications approved for the conditions listed above.

How do side effects of risperidone in males compare with those in females?

Side effects of risperidone are expected to be the same in males and females.* But some side effects caused by risperidone can cause different symptoms in males and females.

For instance, high levels of the hormone prolactin can happen in anyone taking risperidone. But symptoms caused by this side effect differ between males and females. High prolactin levels can cause:

• erectile dysfunction
• missed periods

If you’d like to know more about this, talk with your doctor.

* Sex and gender exist on spectrums. In this article, we use the terms “male” and “female” to refer to a person’s sex assigned at birth.

What brand-name drugs are available for risperidone?

Risperidone is a generic medication. In the United States, these brand-name versions of risperidone are available:

• Risperdal, which comes as tablets and a solution that are taken by mouth
• Risperdal Consta, Perseris, and Uzedy, which are given by injection

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generics usually cost less than brand-name drugs. And they’re thought to be as safe and effective as the brand-name versions.

These brand-name versions of risperidone may have differing uses. Talk with your doctor to learn more about your treatment options, including brand-name versions.

Is withdrawal possible with risperidone?

Maybe. “Withdrawal” refers to symptoms caused by stopping treatment with a medication, especially if it’s stopped suddenly.

Withdrawal was reported in some studies of risperidone. But it’s not clear what symptoms happened due to withdrawal or how long they lasted.

Keep in mind that stopping treatment with risperidone can lead to symptoms of your condition coming back. If you’re interested in ending treatment, do not stop taking the drug without talking with your doctor first. They can advise how to stop taking the drug safely. They can also suggest other treatments for your condition.

Does risperidone cause long-term side effects?

Yes, in some cases risperidone may cause long-term side effects. These can occur if you take the drug for a long time. Or they can last for a while after you’ve stopped taking the drug.

Examples of long-term side effects caused by risperidone include:

• High levels of the hormone prolactin, which can lead to symptoms such as erectile dysfunction and missed periods. This side effect may last throughout treatment.
• Metabolic problems, including weight gain, high cholesterol, and type 2 diabetes. These may not go away, even if treatment is stopped.
• Problems with the body’s ability to regulate body temperature. The risk for this side effect usually goes away once treatment is stopped.
• Tardive dyskinesia, which is a condition that causes uncontrolled movements, such as twitches. This side effect may not go away, even if treatment is stopped.

Talk with your doctor to learn more about these side effects and how to manage them best. Ask your doctor for more information about how long these side effects may last.

Dosage of risperidone

The dosage of risperidone your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking risperidone

Risperidone oral tablet and oral solution are taken by swallowing, with or without food.

Risperidone orally disintegrating tablet is taken by mouth, with or without food. It dissolves when placed in the mouth.

Your doctor will talk with you about how to take risperidone. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Overdose of risperidone

You should not take more risperidone than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much risperidone, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Interactions and warnings for risperidone

Below, you’ll find information about risperidone’s possible interactions and warnings.

Interactions of risperidone

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you use risperidone, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription drugs
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for risperidone” section below.

Warnings for risperidone

Some people should not take risperidone, and others should take it cautiously.

Boxed warning: Increased risk of death in certain older adults

Risperidone has a boxed warning about an increased risk of death in certain older adults. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

Older adults with psychosis related to dementia have this risk when taking an antipsychotic medication, according to studies. In general, “older adults” refers to people ages 65 years and older. (Keep in mind that risperidone is an antipsychotic drug.) It’s not fully understood why this increased risk occurs with antipsychotic drugs.

In the studies, the risk in this group of people was almost twice as high compared with people taking a placebo. (A placebo is a treatment with no active drug.) Causes of death in the studies included stroke, heart failure, and pneumonia.

Due to this risk, risperidone and other antipsychotic drugs are not approved to treat dementia-related psychosis. To learn more, talk with your doctor or pharmacist.

Other warnings

Risperidone could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether risperidone is a safe option for you.

Ask your doctor about specific warnings for risperidone, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Risperidone can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to risperidone or any of its ingredients, your doctor will likely not prescribe risperidone. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

Also, drug rash with eosinophilia and systemic symptoms (DRESS) has rarely been reported with risperidone. DRESS is a type of severe allergic reaction. It causes symptoms such as erupting skin rash, fever, and inflammation in internal organs such as the kidneys.

If you have an allergic reaction to risperidone, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and risperidone

Information about risperidone and pregnancy and breastfeeding is described below.

Risperidone and pregnancy

There are risks with taking risperidone during pregnancy. But there are also risks with having untreated schizophrenia or bipolar I disorder while pregnant. (Keep in mind that risperidone is taken to manage these conditions.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about possible treatments for your condition during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether you should take risperidone during pregnancy.

If you and your doctor decide you’ll take risperidone while pregnant, consider joining the drug’s pregnancy registry. Pregnancy registries provide information to help doctors and patients make safe treatment decisions during pregnancy. You can learn more or join the registry by calling 866-961-2388 or visiting this website.

Risperidone and breastfeeding

Breastfeeding while taking risperidone could cause side effects in the breastfed child. These include sleepiness, tremors, and failing to gain weight as expected. But there are also risks to stopping treatment with risperidone.

If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with risperidone.

Risperidone coupon

You may be able to save money on your prescription for risperidone by using our Optum Perks discount coupons. They can be found at the end of this article.

If you have questions about how to pay for risperidone, talk with your doctor or pharmacist.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

What to ask your doctor

This article describes risperidone’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about risperidone or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Can you tell me more about how long risperidone stays in your system?
• How does the risk of weight gain with risperidone compare with other antipsychotic medications?
• How do oral forms of risperidone compare with long-acting injectable forms?
• Am I at higher risk for side effects with risperidone based on my medical history?

Article resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Risperidone tablets, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/6058a15f-f4f6-44db-ac5a-ec5da409b8d0/spl-doc
• Risperidone oral solution. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/a0a21bec-68f0-444e-a611-d0602859410c/spl-doc
• Risperidone orally disintegrating tablets. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/d0ef6df3-67e5-47b1-bcf7-f67aa030caca/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.