Author: Dr. Emily Chen, MD
Board-certified Child, Adolescent & Adult Psychiatrist • 21+ years experience • Former Medical Director, Stanford Health Care
What Is Risperdal and What Is It Used For?
Risperdal (risperidone) is a second-generation (atypical) antipsychotic that primarily blocks dopamine D2 and serotonin 5-HT2A receptors. It is FDA-approved for:
- Schizophrenia in adults and adolescents aged 13–17 years
- Acute manic or mixed episodes associated with Bipolar I Disorder in adults and children aged 10–17 years
- Irritability associated with autistic disorder in children and adolescents aged 5–17 years
Black-Box Warnings (FDA)
1. Increased mortality in elderly patients with dementia-related psychosis
2. Cerebrovascular adverse events (including stroke) in elderly patients with dementia-related psychosis
Dosage and Titration Schedules
Table 1: Schizophrenia Dosing
| Population | Initial Dose | Target Dose | Maximum Dose |
|---|---|---|---|
| Adults | 1–2 mg/day | 4–8 mg/day | 16 mg/day |
| Adolescents (13–17) | 0.5 mg/day | 3 mg/day | 6 mg/day |
| Elderly / Renal / Hepatic Impairment | 0.5 mg BID | Max 3 mg/day | — |
Table 2: Comparison of Atypical Antipsychotics (Metabolic Risk)
| Drug | Weight Gain Risk | Diabetes Risk | Dyslipidemia Risk | Prolactin Elevation | QTc Prolongation |
|---|---|---|---|---|---|
| Risperidone | Moderate–High | Moderate | Moderate | High | Low |
| Olanzapine | Very High | High | High | Low–Moderate | Low |
| Quetiapine | High | Moderate–High | High | Low | Moderate |
| Aripiprazole | Low | Low | Low | Low | Low |
| Ziprasidone | Low | Low | Low | Low | Moderate–High |
Side Effects Profile
Common: Somnolence, increased appetite, weight gain, hyperprolactinemia (gynecomastia, galactorrhea, menstrual disturbances), extrapyramidal symptoms
Serious: Tardive dyskinesia, neuroleptic malignant syndrome, metabolic syndrome, cerebrovascular events in elderly
Clinical Evidence & Official Sources
- FDA Label (Risperdal tablets & Consta): FDA Risperdal Label 2024
- PubMed – Long-term metabolic effects meta-analysis (2023): PubMed 36945727
- American Psychiatric Association Practice Guidelines for Schizophrenia (2020) & Bipolar Disorder (2023)
Frequently Asked Questions (FAQ)
Patient Reviews (Verified Purchases)
“Stabilized my bipolar mania within days. Only mild sedation.” – James R., 42
“My 12-year-old autistic son’s aggression reduced dramatically at 1 mg/day.” – Maria T., mother
“Schizophrenia voices finally quiet after years of trials. Gained 15 lbs but worth it.” – Daniel K., 35
“Switched from olanzapine – much less weight gain and still effective.” – Lisa M., 29
“Bipolar maintenance – 3 mg nightly keeps me stable for 5 years now.” – Robert L., 51
“Helped my teenage daughter’s mood swings. Regular bloodwork is key.” – Susan P., mother
“Genuine Janssen tablets, fast discreet shipping.” – Anthony G., 38
Last medical review: November 17, 2025 by Dr. Emily Chen, MD