Pharmacology and Therapeutic Uses of Risperidone

Simon M.

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Pharmacology and Therapeutic Uses of Risperidone

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Risperidone, FDA Food and Drug Administration, schizophrenia, anti-psychotic, mental disorder, mental health, healthcare, autism, bipolar disorder, Parkinson, Lewy body dementia

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Abstract

This paper discusses risperidone, a drug commonly used to manage schizophrenia. The common brand name for risperidone is Risperdal. The Food and Drug Administration (FDA) approves risperidone for managing schizophrenia symptoms, bipolar disorder and irritability associated with autism. Schizophrenia is a psychiatric illness presenting with disordered behaviour and thinking, delusions, and hallucinations that can usually affect functioning. It is approved for managing bipolar disorder mixed symptoms in combination with valproic acid or lithium or as monotherapy (Carli et al., 2023). Clinicians use risperidone to manage irritability related to autism in persons aged between 5 and 16 years. Off-label uses of risperidone include treatment of depression, sleep problems, anxiety disorders, obsessive-compulsive disorder, and attention-deficit hyperactivity disorder.

Risperidone and FDA-Approved Uses
Risperidone Leaflet

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[...] They are at risk of experiencing drug accumulation and toxicity due to their reduced ability to eliminate risperidone. Clinicians should titrate the dose slowly to optimize plasma levels of free risperidone drug fraction. Patients with psychosis related to dementia should not receive risperidone (Yunusa & El Helou, 2020). They are at higher risk of death due to infections such as pneumonia or cardiovascular complications, including cardiac arrest or heart failure. Clinicians should consider the risks and benefits of prescribing risperidone to pregnant women. Antipsychotic drugs can cause withdrawal or extrapyramidal symptoms to neonates. [...]

[...] Emerging 5-HT receptor antagonists for the treatment of Schizophrenia. Expert opinion on emerging drugs, 25(2), 189-200. https://doi.org/10.1080/14728214.2020.1773792 Maguire, P. A., Brazel, M., & Looi, J. C. (2024). Antipsychotic-induced acute laryngeal dystonia: A systematic review of case reports. Schizophrenia Research, 264, 248-262. https://doi.org/10.1016/j.schres.2023.12.032 Procyshyn, R. M., Bezchlibnyk-Butler, K. Z., & Kim, D. D. (Eds.). (2023). Clinical handbook of psychotropic drugs. Hogrefe Publishing GmbH. Rüdesheim, S., Selzer, D., Mürdter, T., Igel, S., Kerb, R., Schwab, M., & Lehr, T. (2022). [...]

[...] Physiologically based pharmacokinetic modeling to describe the CYP2D6 activity score-dependent metabolism of paroxetine, atomoxetine and risperidone. Pharmaceutics, 14(8) https://doi.org/10.3390/pharmaceutics14081734 Vasquez, A. R., & Bobo, W. V. (2022). Mood stabilizers: risperidone for treating bipolar disorders in adults. In NeuroPsychopharmacotherapy (pp. 1607-1638). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-62059-2_48 Yunusa, I., & El Helou, M. L. (2020). [...]

[...] About 10% of risperidone is excreted through the kidneys. - Pharmacodynamics of Risperidone Risperidone relieves positive symptoms of schizophrenia, such as delusions and hallucinations. The effect is attributed to the binding to the D2 receptors. However, it attaches to the 5-HT2 receptor with greater affinity than the dopamine receptors. The affinity to the 5-HT2 receptors is higher than that seen in haloperidol and other typical antipsychotics. The blockade of serotonin 5-HT2A receptors in the nigrostriatal pathways enhances dopamine transmission. The increased transmission is responsible for reduced extrapyramidal symptoms, which is normally a challenge for patients on typical antipsychotic drugs. [...]

[...] They must ensure they explain the risks and benefits of prescribing risperidone, for patients to make informed decisions. Patients must be made aware of their right to refuse treatment. Healthcare providers must keep all information concerning the therapy confidential. The confidentiality reduces stigma that may discourage the patient from adhering to the prescribed risperidone dose. They must minimize patient harm by prescribing the correct dose of medications. Therefore, they must conduct comprehensive patient assessment to find and treat preexisting disorder that can adversely affect the treatment outcome. [...]

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