Risdone
Risdone (Risperidone 1/2/3/4 mg) — atypical antipsychotic for schizophrenia, bipolar mania, autism irritability. strong D2 blockade — highest prolactin elevation of atypicals.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Snel antwoord
Risdone (Risperidone 1 / 2 / 3 / 4 mg) is an atypical antipsychotic for schizophrenia, bipolar mania, irritability in autism (paediatric and adolescent), and short-term aggression in dementia. Highest prolactin elevation of any atypical — relevant for fertility, menstrual function, and bone density.
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What Risdone is and how it works
Risdone is a risperidone tablet supplied by Sun Pharma. Available strengths: 1 / 2 / 3 / 4 mg. Risperidone is a strong D2 and 5-HT2A antagonist with α1-adrenergic and H1 antihistamine activity, but minimal anticholinergic effect. The strong D2 blockade explains both the strong antipsychotic effect and the high rate of EPS and prolactin elevation.
Indicaties en dosering
| Indicatie | Startdosering | Streefdosering | Maximaal |
|---|---|---|---|
| Schizophrenia (adult) | 1–2 mg OD or BID | 4–6 mg/day | 16 mg |
| Schizophrenia (adolescent ≥ 13 y) | 0.5 mg OD | 3 mg/day | 6 mg |
| Bipolar mania | 2–3 mg OD | 2–6 mg/day | 6 mg |
| Autism irritability (paediatric ≥ 5 y) | 0.25–0.5 mg OD | 0.5–3 mg/day weight-based | 2.5–3 mg |
| Older adults / dementia (off-label, last-resort) | 0.25 mg OD | 0.5–1 mg/day | 2 mg |
Belangrijke veiligheidsoverwegingen
All atypical antipsychotics carry an FDA black-box warning for increased mortality (mostly cardiovascular and infectious) when used to treat behavioural disturbance in older adults with dementia. Atypicals are not approved for dementia-related psychosis or agitation. Use in this population is off-label, last-resort, time-limited, and requires explicit risk-benefit conversation.
Risperidone produces marked, dose-dependent hyperprolactinaemia. Clinical consequences: amenorrhoea, galactorrhoea, anovulation, and reduced bone density in women; loss of libido, erectile dysfunction, and gynaecomastia in men; in long-term use, accelerated osteoporosis. Check prolactin if symptoms suggest hyperprolactinaemia. If hyperprolactinaemia is symptomatic, consider switching to aripiprazole (lowers prolactin) or quetiapine.
Above approximately 6 mg/day, risperidone increasingly behaves like a typical antipsychotic on EPS — rigidity, tremor, akathisia, dystonia. Tardive dyskinesia risk is real but lower than typicals. Stay below 6 mg/day where possible.
α1 antagonism — common at initiation, particularly in older adults. Titrate slowly.
Less than olanzapine but real — weight gain typically 2–4 kg over 6 months. Monitor weight, fasting glucose, fasting lipids at baseline, 12 weeks, then 6-monthly.
Veelvoorkomende bijwerkingen
- Hyperprolactinaemia and downstream effects — distinguishing feature.
- EPS / akathisia — dose-dependent.
- Sederende werking, slaperigheid — common but moderate.
- Gewichtstoename — moderate.
- Orthostatic hypotension — common at initiation.
- Anxiety, insomnia — common.
- Sialorrhoea (drooling) — particularly in clozapine-experienced patients.
Geneesmiddelinteracties
- Strong CYP2D6 inhibitors (paroxetine, fluoxetine, bupropion, quinidine) — raise risperidone levels; halve dose.
- Sterke CYP3A4-induceerders (rifampicin, carbamazepine, phenytoin) — reduce levels; may need dose increase.
- Andere QT-verlengende geneesmiddelen — additive risk.
- Antihypertensiva — additive orthostasis.
- CNS depressants — additive sedation.
Zwangerschap, borstvoeding, pediatrie
Pregnancy: limited data; late-pregnancy exposure can produce neonatal EPS or withdrawal. Breastfeeding: passes into milk; usually requires monitoring. Paediatric: licensed from 5 (autism), 10 (bipolar), 13 (schizophrenia).
Opslag
Bewaren bij 15–30 °C in originele verpakking.
Veelgestelde vragen
Why does Risdone cause amenorrhoea / breast effects / sexual dysfunction?
Risperidone has the strongest dopamine D2 blockade among atypicals, and the pituitary lactotroph is regulated by tonic dopamine inhibition. Block D2 in the pituitary, and prolactin rises — sometimes 5–10× normal. The downstream hormonal effects (amenorrhoea, galactorrhoea, sexual dysfunction, accelerated osteoporosis) are common. Switching to aripiprazole or quetiapine usually normalises prolactin within weeks.
How is Risdone different from olanzapine?
Risperidone has a stronger acute antipsychotic effect for many positive symptoms but produces more EPS and far more hyperprolactinaemia. Olanzapine is metabolically heavier but doesn’t affect prolactin much. Choice depends on patient priorities: avoid weight gain → risperidone; avoid prolactin/EPS → olanzapine or aripiprazole.
Will Risdone make me gain weight?
Yes — moderate, typically 2–4 kg over 6 months. Less than olanzapine or quetiapine, more than aripiprazole or lurasidone.
Can Risdone be used in children?
Yes — risperidone is one of the most-prescribed atypicals in paediatrics, particularly for autism-associated irritability (FDA approval from age 5) and bipolar disorder (from age 10). Long-term use in children carries growth and prolactin concerns; specialist supervision recommended.
How long until Risdone works?
Acute calming and reduced agitation within hours of the first oral dose. Antipsychotic effect on positive symptoms usually within 1–2 weeks; full effect at 4–6 weeks. Bipolar mania response within days.
What about the orodispersible form?
Risperidone is also available as an orodispersible MT formulation that dissolves on the tongue — useful in acute psychosis or dysphagia.
Are LAI versions available?
Yes — Risperdal Consta (biweekly), Perseris (monthly subcutaneous), and Uzedy (monthly or bimonthly) are the three depot risperidone formulations, used for adherence support. The oral form is the standard initiation and titration formulation.
What about driving on Risdone?
The first 1–2 weeks of titration can impair reaction time. Most patients on stable doses drive normally. Avoid alcohol and other CNS depressants when driving.
Can Risdone be stopped abruptly?
Taper over 2–4 weeks. The relapse risk in schizophrenia and bipolar disease is the main reason for caution.
Does Risdone prolong the QT interval?
Modest effect; less than ziprasidone or thioridazine. Pre-treatment ECG is not routinely required but is reasonable in patients with cardiac risk factors.
Andere medicijnen voor geestelijke gezondheid
- Aripicon (Aripiprazole — D2 partial agonist)
- Olanzap (Olanzapine — robust antipsychotic)
- Risdone (Risperidone)
- Seroquit (Quetiapine — bipolar depression)
- Atlura (Lurasidone — metabolically clean)
Meer opties in Mentale Gezondheid en Psychiatrische Medicatie
Gerangschikt op recente bestelvolumes van MedsBase — wat andere klanten in deze categorie kiezen.
| Sterkte | 1 mg |
|---|---|
| Hoeveelheid | 30 Tabletten, 60 Tabletten, 90 Tabletten, 180 Tabletten |
Risdone
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