Risperdal Patient Tips

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 17, 2025.

1. How it works

• Risperdal is used to treat schizophrenia, acute manic or mixed episodes of Bipolar I Disorder, or irritability associated with autistic disorder. It a brand name for risperidone.
• Risperidone blocks dopamine and serotonin receptors in the brain, helping regulate neurotransmitter activity. This reduces symptoms of schizophrenia, bipolar disorder, and irritability in autism by restoring chemical balance. Other effects may be due to it blocking other neurotransmitter receptors.
• Risperdal belongs to the drug class called atypical antipsychotics. Atypical means these antipsychotics are less likely than older antipsychotics to cause movement-related side effects.

2. Upsides

• Used to treat schizophrenia. Relieves psychotic symptoms such as hallucinations, delusions, confusion, disturbed thoughts, and lack of insight or self-awareness.
• Used either alone or in combination with lithium or valproate for acute manic or mixed episodes of Bipolar I Disorder.
• Used to relieve irritability associated with autistic disorder in children. May help with symptoms of aggression, temper tantrums, and mood fluctuations.
• People are more likely to adhere to treatment with Risperdal than to treatment with older antipsychotics.
• Not a controlled substance.
• Risperdal is available as a generic under the name risperidone.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Drowsiness which may affect your ability to drive or operate machinery. Avoid alcohol.
• Extrapyramidal symptoms (such as restlessness, tremors, and uncontrolled muscle contractions) are more likely at dosages greater than 6mg/day. Higher dosages have also not been associated with extra efficacy. Dosages for adolescents should be limited to 3mg/day to limit the risk of side effects.
• Other common side effects include anxiety, blurred vision, dizziness, gastrointestinal disturbances (nausea, vomiting, constipation, diarrhea, dyspepsia, pain), excessive salivation, tiredness, weight gain, and rash. Uncommonly, a reduction in the number of white blood cells, swallowing difficulty, priapism (sustained erections), and seizures may occur.
• A drop in blood pressure on standing, particularly during the initial dose titration period; the dosage may need to be reduced then titrated up slowly. May not be suitable for people with known cardiovascular disease (history of a heart attack, angina, heart failure, or arrhythmia), stroke, and people at risk of dehydration.
• An increase in blood sugar levels. People with a history of diabetes or at risk of diabetes should be monitored closely. May also cause undesirable changes in blood cholesterol and lipid levels and weight gain (on average, 4.3kg after 6 months of therapy).
• An increase in prolactin levels (risk is higher than with most other antipsychotics), leading to side effects such as impaired fertility, an absence of menstruation, unwanted lactation, breast enlargement in men, impotence, and decreased bone density. May not be suitable for people with a history of prolactin-dependent breast cancer.
• Potentially irreversible tardive dyskinesia, even with low dosages used short-term. Symptoms include facial grimacing, repetitive chewing, and tongue thrusting.
• May interact with some medicines. The dosage may need to be increased when used with enzyme inducers such as carbamazepine or phenytoin; the dosage may need to be reduced when used with enzyme inhibitors such as fluoxetine or paroxetine. See the prescribing information for Risperdal for the full list of interactions.
• Should not be used for the treatment of dementia-related psychosis in elderly people as it has been associated with a higher risk of death.
• Rarely, may cause Neuroleptic Malignant Syndrome (NMS); symptoms include high body temperature, muscle rigidity, and mental disturbances; discontinue immediately and seek urgent medical advice.
• There are no controlled studies investigating the use of Risperdal in pregnant women. Neonates exposed to antipsychotic agents, such as risperidone, in the third trimester, are at risk for extrapyramidal or withdrawal symptoms following delivery. Only use in pregnancy if the potential benefits justify the risk. Risperdal and its metabolites are present in breast milk, and breastfeeding while taking risperidone is not recommended.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

• Risperdal treats schizophrenia by relieving psychotic symptoms like hallucinations and delusions. It also treats manic or mixed episodes of Bipolar I Disorder and autism-related irritability in children. Overall, people show better treatment adherence with Risperdal than with older antipsychotics. Side effects include drowsiness and movement disorders at higher doses. Alcohol should be avoided. Risperdal should not be used for the treatment of people with dementia-related psychosis.

5. Tips

• Risperdal should be started at a lower dose initially and then gradually titrated up depending on an individual's response and tolerability. Follow your doctor's instructions.
• Some people are more sensitive to the effects of Risperdal and may need a more gradual increase in dosage - talk with your doctor if you are having trouble tolerating any side effects of Risperdal.
• Ask your doctor about splitting your daily dose of Risperdal into a morning and evening dose if you find Risperdal makes you too sleepy during the day. Do not drive or perform hazardous tasks if Risperdal makes you sleepy.
• Avoid alcohol as it may potentiate the sedative effect of Risperdal.
• Risperdal may be used long-term; however, a doctor should periodically reevaluate its effectiveness and monitor for the presence of side effects. When used to delay relapse in people with schizophrenia, effectiveness in trials has lasted for at least 2 years (the duration of the trial).
• Risperdal may make you feel dizzy when going from a sitting or lying down position to standing. This may increase your risk of falls. Stand up slowly and remove any fall hazards from your home (such as loose rugs).
• Talk with your doctor if you develop any worrying side effects such as uncontrollable facial grimacing, restlessness, severe dizziness, or severe abdominal discomfort.
• Tell your doctor if you intend to become pregnant and you are taking Risperdal as your doctor may wish to change you to a different medication. Risperdal is incompatible with breastfeeding.

6. Response and effectiveness

• Some effects may be noticed within a few days but it may take up to three to four weeks for the full effects of Risperdal to be seen.
• Risperdal is metabolized to an active metabolite, 9-hydroxy-risperidone.
• Risperdal orally disintegrating tablets, Risperdal oral solution, and Risperdal tablets are all bioequivalent (this means that there is no difference in the extent to which they are absorbed and their effect at the same dosage).

7. Interactions

Medicines that interact with Risperdal may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Risperdal. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Risperdal include:

• antidepressants such as citalopram, escitalopram, or fluoxetine
• antipsychotics such as aripiprazole, clozapine, or haloperidol
• azelastine
• bupropion
• clozapine
• cisapride
• CYP2D6 inhibitors or inducers, such as fluoxetine
• CYP3A4 inducers, such as carbamazepine, oxcarbazepine, phenytoin, rifampin, St John's Wort
• CYP3A4 inhibitors, such as clarithromycin, cyclosporine, fluconazole, ketoconazole, nefazodone, ritonavir, tamoxifen, verapamil
• diuretics, such as furosemide or hydrochlorothiazide
• droperidol
• heart medications, such as amlodipine, betaxolol, candesartan, carisprodol
• HIV medications, such as indinavir, nelfinavir, ritonavir, and saquinavir
• insulin
• ipratropium or tiotropium
• glucagon
• kava kava
• lithium
• magnesium sulfate
• medications used to treat Parkinson's Disease, such as cabergoline and levodopa
• nitroglycerin
• opioids, such as alfentanil, fentanyl, buprenorphine, methadone, or oxycodone
• pimozide
• potassium chloride
• QT-prolonging medications, such as amiodarone, clarithromycin, domperidone, flupentixol, sotalol, or voriconazole
• tramadol
• valproate
• zolpidem.

Avoid drinking alcohol or taking illegal or recreational drugs while taking Risperdal.

Note that this list is not all-inclusive and includes only common medications that may interact with Risperdal. You should refer to the prescribing information for Risperdal for a complete list of interactions.

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Risperdal only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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