Risperidone: What It Does and How to Use It Safely

Risperidone is an antipsychotic used to treat schizophrenia, bipolar mania, and irritability linked to autism. It changes how certain brain chemicals work to reduce hallucinations, mood swings, and aggression. Doctors prescribe it when symptoms interfere with daily life or safety.

Risperidone comes as tablets, a dissolving tablet, and long-acting injections. The right form depends on how steady you want blood levels and whether you can take pills every day.

Common doses and practical tips

Adults with schizophrenia usually start low and increase slowly. Typical oral doses range from 1 mg to 6 mg per day, split into one or two doses. For bipolar mania initial doses often start at 2 mg per day. Long-acting injections are given by a clinician every 2 weeks or monthly depending on the product.

Always follow your prescriber's instructions. If you miss a dose, take it as soon as you remember unless it’s nearly time for the next dose. Don’t double doses to catch up.

Side effects, risks, and what to watch for

Common side effects include drowsiness, weight gain, increased appetite, and dry mouth. Some people notice stiffness, tremors, or restlessness — these are movement-related side effects called extrapyramidal symptoms (EPS).

Risperidone can raise blood sugar, cholesterol, and prolactin (a hormone). If prolactin rises you may see irregular periods, breast changes, or sexual side effects. Your doctor will usually check weight, fasting blood sugar, and lipids at baseline and during treatment.

Rare but serious risks include tardive dyskinesia (involuntary movements) and neuroleptic malignant syndrome (high fever, muscle rigidity). Seek urgent care if you have sudden high fever, severe stiffness, difficulty breathing, or jaw and tongue movements.

Older adults with dementia-related psychosis have an increased risk of death on antipsychotics. Risperidone is generally avoided for dementia-related behavior except in specific situations and with close monitoring.

Risperidone interacts with medicines that affect liver enzymes (CYP2D6 and CYP3A4). Strong inhibitors can raise risperidone levels and increase side effects. It can also add to medicines that prolong QT interval — check with your prescriber or pharmacist.

Pregnancy and breastfeeding: use needs careful discussion. Risperidone may cause neonatal withdrawal or movement issues if used in late pregnancy. Breastfeeding while on risperidone should be reviewed with your doctor.

Thinking of stopping? Don’t stop suddenly. Taper slowly under medical advice to reduce withdrawal or symptom return. Keep follow-up appointments and report new symptoms quickly.

Buying online: only use licensed pharmacies and require a prescription. Verify the pharmacy’s credentials, check reviews, and avoid sites offering prescription drugs without a script. If unsure, ask your local pharmacist for help.

Final practical note: keep a list of all meds, watch weight and mood, and get regular blood tests as advised. If side effects are troublesome, your doctor can adjust dose, switch drugs, or add medicines to manage symptoms.