Risperidone is a second‑generation (atypical) antipsychotic prescribed for schizophrenia, acute manic or mixed episodes of bipolar I disorder, and irritability associated with autistic disorder. It works primarily by blocking dopamine D2 and serotonin 5‑HT2A receptors in the brain, helping to rebalance neurotransmitters linked to mood, thought, and behavior.

Approved Uses and Benefits

In schizophrenia, risperidone reduces hallucinations, delusions, and disorganized thinking

For bipolar mania, it alleviates elevated mood, excessive energy, and irritability

In children with autism, it decreases aggression, self‑injury, and severe tantrums

Dosing Guidelines

Adults typically start at 1 mg twice daily or 2 mg once daily, titrating by 1 mg every 1–2 days to an effective range of 4–6 mg daily

Pediatric dosing for autism‑related irritability begins at 0.25 mg (ages 5–16) once or twice daily, increased gradually

Take with or without food; consistent timing helps maintain stable blood levels

Common SideEffects

Sleepiness, fatigue, and dizziness often occur early but may diminish over weeks

Weight gain and increased appetite require monitoring of diet and exercise

Extrapyramidal symptoms—tremor, rigidity, or akathisia—can emerge, especially at higher doses

Hyperprolactinemia may cause menstrual irregularities or breast changes

Monitoring and Safety

Baseline metabolic panel, lipid profile, and weight

Periodic checks of fasting glucose, lipids, and prolactin

Watch for signs of movement disorders; consider dose adjustment or alternative therapy if needed

Avoid alcohol and use caution with other central nervous system depressants

Tapering and Discontinuation

Abrupt stop can cause withdrawal symptoms—insomnia, nausea, return of psychosis

Gradually reduce dose over weeks under medical supervision

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When used and monitored properly, risperidone provides significant symptom relief across multiple psychiatric conditions. Work closely with your healthcare provider to optimize dosing, manage side effects, and ensure the safest, most effective therapy.