Risperdal (Risperidone): Uses, Side Effects, Dosage, & More

How Does Risperdal Work?

Risperdal works to affect the amount of chemicals in your brain that may trigger symptoms in schizophrenia and bipolar I disorder. These chemicals, dopamine, and serotonin, are altered within the body. Once Risperdal is broken down into its active ingredient, the decreased availability of dopamine and serotonin helps to balance the chemicals in the brain, which helps to reduce unwanted thoughts and behaviors in those coping with schizophrenia, bipolar I disorder, and irritability in autistic disorder.

Is Risperdal Available as a Generic Medication?

Risperdal is available as a generic, which goes under the name risperidone. For disintegrating tablets, only the generic version is available as the brand name Risperdal M-Tab is now discontinued and no longer available from the manufacturer.

Is Risperdal the Same As Xanax?

Risperdal is not the same as Xanax. They both have sedating effects, but they are not used in the same way, and they are not used for the same conditions. Xanax is a benzodiazepine used to treat anxiety disorders, while Risperdal is an atypical antipsychotic that treats schizophrenia, bipolar mania, and irritability associated with autistic disorder.

What Is Risperdal Used to Treat?

Risperdal is used in the treatment of schizophrenia, mania in bipolar I disorder, and irritability in autistic disorder. These are FDA-approved uses which means that the drug’s effect has been reviewed and determined to provide benefits and that it meets safety standards for the population it is approved for. In schizophrenia, Risperdal can be used in adults and children 13 years and older. In the treatment for bipolar disorder, adults and children who are at least ten years old can use Risperdal. To treat irritability in children with autistic disorder, Risperdal is indicated for ages 5 to 16 years old.^1,2

Risperdal can also be used off-label, which means that a medication is used for a use other than what is FDA-approved. This can be done if the doctor decides the medication’s benefit outweighs the risks in their professional judgment. Risperdal has been used off-label in the treatment of Tourette syndrome.⁴ Risperdal has multiple uses, but for this article, its use in the treatment of schizophrenia and bipolar disorder will be the focus.

Common Side Effects of Risperdal

Along with its intended effects, Risperdal may cause unwanted effects. Some side effects may occur that do not require medical attention and may go away during treatment as the body adjusts to the medication. Common adverse reactions associated with Risperdal usually involve its effects on a person’s movements, potentially resulting in muscle spasms, tremors, and restless movements. If these side effects are bothersome, you should talk with your doctor.

Common side effects of Risperdal include:*^1,2

• Increased weight
• Restlessness
• Muscle spasms
• Tremor
• Anxiety
• Blurred vision
• Sedation

*All medications, including Risperdal, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Risperdal

Ripserdal, like all medications, has side effects that a person could experience which requires them to seek medical attention. Some of these serious side effects are rare, but they could lead to serious, sometimes fatal, reactions and should be addressed immediately by a medical professional. Risperdal is also known to affect the motor functions of a person and sometimes their cognitive functions due to side effects like sedation and low blood pressure when standing.

Serious side effects of Risperdal include:*^1,2

• Coughs, chills, and other signs of an infection
• Painful erection of the penis that lasts for hours
• Rash; itching; hives; swelling of the face, throat, lips, and eyes
• Cognitive/motor impairment (i.e. confusion, slow movements, shuffling walk, etc.)
• Seizures

*All medications, including Risperdal, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Risperdal Warnings & Precautions

Risperdal, as with all medications, have warning and precautions that should be taken into consideration when they are prescribed. These warnings should be discussed with a doctor, especially if the patient has a condition or is on medications that may increase the risk of experiencing a complication. Medical attention may be required if a patient was to experience a side effect. These are warnings, and not all patients will experience them while on Risperdal. Medical professionals are trained to assess risks and benefits, and concerns should be discussed with them.

Talk with your doctor about Risperdal if you:^1,2

• Are elderly and diagnosed with dementia-related psychosis: There is an increased risk of death and cerebrovascular incidents (e.g. stroke) in elderly patients with dementia-related psychosis.
• Have allergic reactions: Those who are allergic to risperidone, or paliperidone, and its components should not take this medication as
• Have diabetes or hyperglycemia: Risperdal can cause metabolic changes and worsen control of blood sugar.
• Have concerns about tardive dyskinesia: There is a risk of developing this condition while on Risperdal. There isn’t a way to predict which patients will develop the syndrome, but it appears to be more prevalent in the elderly, especially elderly women.
• Have dyslipidemia:  Risperdal can alter the levels of cholesterol and fats in the body.
• Have concerns with weight gain: Weight gain has been observed in atypical antipsychotic usage. Weight should be monitored while a person is on Risperdal.
• Are at risk for falls: Drowsiness, low blood pressure when standing, and motor and sensory instability have been issues reported with the usage of Risperdal. These side effects can increase the risk of falls and injury or patients with disease, conditions, or medications that exacerbate these effects.

Risperdal Dosages for FDA-Approved Treatment

Dosages can vary from person to person, depending on a person’s age, the condition being treated, and what medications or conditions they currently have. Typically an effective dosage range for schizophrenia in adults is 4 to 16 mg adults with Bipolar mania are typically at a dosage range of 1 to 6 mg.^1,2 Prescribers will start a patient on a lower dosage and increase the amount until your symptoms are managed.

Risperdal Forms & Strengths

Risperdal has three different dosage forms: an oral tablet, an oral disintegrating tablet, and an oral solution. They are immediate-release medications. A doctor may prescribe one form over another depending on factors like your ability to swallow medications and if you are capable of taking the medication correctly. Keep in mind that it may take 4 to 6 weeks to see the full benefits of Risperdal.

Risperidone also comes in an extended-release injectable form where it can be injected into the muscle (Risperdal Consta and Rykindo) or under the skin (Perseris). These dosage forms will not be discussed within the article as they are only given within a healthcare setting.

Risperdal is available in the following forms and strengths:^1,2

• 0.5 milligram (mg) oral tablet
• 1 milligram (mg) oral tablet
• 2 milligrams (mg) oral tablet
• 3 milligrams (mg) oral tablet
• 4 milligrams (mg) oral tablet
• 1 milligram (mg) per milliliter (mL) oral solution
• 0.5 milligram (mg) disintegrating oral tablet
• 1 milligram (mg) disintegrating oral tablet
• 2 milligrams (mg) disintegrating oral tablet
• 3 milligrams (mg) disintegrating oral tablet
• 4 milligrams (mg) disintegrating oral tablet

What’s the Most Effective Dose of Risperdal?

The most effective dose of Risperdal varies from person to person. This can depend on several factors, such as your diagnosis, how you respond to the medication and other personal factors. What other medications you take can impact what is the most effective dose of Risperdal for a person. The most effective dose will be the dosage that controls a person’s symptoms for their specific condition with the fewest amount of tolerable side effects.

How Should I Take Risperdal?

Risperdal is usually prescribed once or twice daily, and it is recommended to take it at the same time every day. Do not take more or less of the medication or more often than prescribed by your prescriber. It is important to take Risperdal exactly as prescribed to ensure maximum efficacy and safety. This medication can be taken with or without food, although the oral solution has specific dietary restrictions.

For the oral solution, use the oral dosing syringe provided to measure your dose. The oral solution can be taken with water, orange juice, coffee, or low-fat milk. It should not be taken with tea or cola. For the orally disintegrating tablets, do not open the blisters until you are ready to take them. Immediately place the tablet on the tongue, where it will disintegrate within seconds and can be swallowed subsequently with or without liquid. Do not split or chew the tablet. ^1,2,3

What Happens If I Miss a Dose of Risperdal?

If a dose of Risperdal is missed, then it should be taken as soon as you remember it. If it is almost time for the next dose, then skip the dose you missed and take the next scheduled dose. It is important that patients do not double up the dose to make up for the missed one.

Can You Overdose on Risperdal?

It is possible to overdose on Risperdal. Signs and symptoms of an overdose with Risperdal are intense severity of the drug’s known side effects, i.e., drowsiness and sedation, fast heart rate and low blood pressure, and effects on a person’s movements. Someone experiencing an overdose may see muscle spasms and contractions, restlessness, rigidity, slowed movements, or irregular and jerky movements. Other adverse reactions reported during a Risperdal overdose included convulsions and a change to the heart’s rhythm, including a prolonged QT interval.

What Should You Do If You Take Too Much Risperdal?

If you have mistakenly taken too much Risperdal, contact poison control at 1-800-222-1222 for further instructions. These medical professionals can help you determine if you need further medical attention based on how much you took and at what time you took the dose. If you experience serious side effects, you should call 911 or visit your nearest emergency room for further intervention.

What to Avoid When Taking Risperdal

Risperdal’s effect on serotonin and dopamine can mean that it may interact unfavorably with other substances. These two chemicals are used in many processes within the body, so when it is combined with a substance such as alcohol, it may cause an exaggerated effect that could be dangerous. When combined with medications like alcohol, centrally-acting drugs, or drugs that cause lower blood pressure, the risk of falls may increase alongside sedation and confusion.

5 substances you should avoid while taking Risperdal include:^1,2

• Alcohol and substances that affect the central nervous system: Risperdal can cause drowsiness, combination of alcohol or other medication that works on the central nervous system (CNS) may increase the risk of effects like sedation and falls. Examples of these types of medications would be blood pressure medications, sedatives, etc.
• Methylphenidate: When there is a change in the dosage of either medication, it may increase the risk of extrapyramidal symptoms (EPS), a drug-induced movement disorder.
• Clozapine: This medication may decrease the clearing of Risperdal from the body, resulting in unintended side effects.
• Levodopa and dopamine agonist drugs: Risperdal may antagonize the intended effects of these types of medications, which are usually used in Parkinson’s disease.
• Drugs that can result in lower blood pressure: Risperdal may induce low blood pressure, and combined with other medications that have similar effects, the effect may be enhanced.

Risks of Abrupt Discontinuation of Risperdal

If Risperdal is stopped abruptly, this can result in an unwanted reaction called a withdrawal. Withdrawal happens when a medication is stopped abruptly, or the dosage is reduced all of a sudden and can result in experiencing unpleasant side effects. If you are thinking of stopping Risperdal, consult your physician first and follow their instruction to gradually taper off the medication to avoid withdrawal symptoms.

How to Get a Prescription for Risperdal

Risperdal is only available via a prescription from a licensed healthcare provider with prescribing authority, such as a physician or psychiatric advanced practice nurse (APRN). To get a prescription for Risperdal, one must have a valid diagnosis which can be determined through a series of tests, ruling out any other possible diagnosis or reason for a person’s symptoms.

How Much Does Risperdal Cost?

The cost of Risperdal will depend on whether you have insurance or are paying with cash. If you have insurance, the price will vary depending on your copay, deductible, and other factors. Brand-name Risperdal will generally be more expensive than the generic. If you are paying without insurance, discount cards may be available to lower the cost of the medication.

Questions to Ask Your Healthcare Provider About Risperdal

If you are considering taking Risperdal, meet with your doctor with a list of questions to ask. Questions you should ask your doctor or psychiatrist are the expectations with Risperdal, what are the expected side effects, and how this medication works in your overall therapy. If it is burdensome to meet with a doctor in person, online psychiatry services may be a good option if you need a change in prescribers.

Questions to ask your care team about Risperdal include:

• How safe is Risperdal?
• How long will it take for me to adjust to taking Risperdal?
• Am I at risk for more serious symptoms if I am already taking other medications?
• What is the best dosage to ensure fewer side effects?
• Should I take Risperdal if I’m planning on becoming pregnant or currently am pregnant?
• What should I do if I think Risperdal is affecting my motor functions?
• Does Risperdal interact with any of my current medications?
• Are there other alternatives to Risperdal that I should consider?

For Further Reading

• How Is Bipolar Disorder Diagnosed?
• How to Help Someone With Schizophrenia: 10 Tips From a Therapist
• Autistic Self Advocacy Network (ASAN)
• Rexulti (Brexpiprazole): Uses, Side Effects, Warning, & More