Medication Guide
Risperidone (Risperdal) Side Effects and Uses
A plain-language guide to Risperidone, an atypical antipsychotic. Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Risperidone (Risperdal) is an atypical antipsychotic. Common risperidone side effects include sleepiness or tiredness, bigger appetite and weight gain, restlessness or tremor and stiff muscles. The rare but serious ones, and when to get help, are listed under risperidone side effects below. Never stop or change your dose on your own.
How Risperidone Can Help You
Risperidone is sold as Risperdal. It calms overactive dopamine and serotonin signals in the brain. This can ease voices, false beliefs and mixed-up thinking. It can also ease severe agitation and mania. It is one of the most studied drugs of its kind. It is also approved for irritability linked to autism in kids and teens.
Agitation and sleep often get better in the first few days. Voices and mania usually respond over two to six weeks. People often say it feels like the volume turning down on voices or unwanted thoughts. Mood feels steadier. It gets easier to think and talk clearly.
Risperidone works well at fairly low doses. Your prescriber uses the lowest dose that helps. This keeps side effects such as stiffness or restlessness low.
Uses for Risperidone
- Schizophrenia in adults and teens
- Bipolar I mania or mixed episodes
- Irritability linked to autism
- Bipolar maintenance with a mood stabilizer (off-label)
- Tic disorders (off-label)
- Severe agitation or aggression (off-label)
How to Take Risperidone
Risperidone is taken once or twice a day, with or without food. It comes as tablets, tablets that melt in the mouth and a liquid. There are also long-acting shots for people who would rather not take a daily pill. Your prescriber decides the form and dose. They change it slowly.
Your prescriber will check weight, blood sugar and cholesterol from time to time. Risperidone raises the hormone prolactin more than most drugs like it. So your prescriber may check a prolactin level. This is more likely if you notice breast changes, missed periods or sexual side effects.
If you miss a dose, take it when you remember, unless the next dose is near. Never double up. Do not stop risperidone all at once, because symptoms can come back. Plan any taper with your prescriber.
Risperidone Side Effects
Common Side Effects
- Sleepiness or tiredness
- Bigger appetite and weight gain
- Restlessness or tremor
- Stiff muscles
- Dizziness
- Nausea or constipation
- High prolactin (breast or period changes)
- Stuffy nose
Serious: Get Medical Help Promptly
- Death risk in older adults with dementia and psychosis (boxed warning)
- Tardive dyskinesia (movements you cannot control, which may last)
- Neuroleptic malignant syndrome (high fever, stiff muscles, confusion)
- High blood sugar or new diabetes
- Fainting from low blood pressure
- Low white blood cell count
- Long, painful erection (priapism), an emergency
How Risperidone Works
Risperidone is a newer, second-generation antipsychotic. It blocks dopamine D2 receptors and serotonin 5-HT2A receptors. Blocking D2 in some brain pathways calms the extra signals tied to voices, false beliefs and mania. The strong serotonin block is thought to lower the chance of some movement side effects. Older drugs cause more of them.
Risperidone also blocks some adrenaline and histamine receptors. That is why it can cause dizziness when you stand up. It is also why it can make you sleepy. In the body, risperidone turns into an active form called 9-hydroxyrisperidone. That same form is sold as its own medicine, paliperidone.
What Risperdal Is Used For at Different Ages
Risperdal is the brand name. Risperidone is the generic name. The FDA has approved it for schizophrenia in adults and teens 13 and older. It is approved for bipolar I mania or mixed episodes in adults. That use is also approved in kids and teens 10 and older.
It is also approved for irritability linked to autism in kids and teens 5 to 16. That can mean hitting, self-harm, tantrums and moods that change fast. For young people, prescribers watch weight, growth and lab tests closely. Families can learn more about child and adolescent psychiatry by telehealth from anywhere in California.
Before You Start Risperidone
Tell your prescriber if you have diabetes, heart disease or low blood pressure. Also share seizures or trouble swallowing. Say if you ever had a low white blood cell count. People with Parkinson's disease or Lewy body dementia can be more sensitive to drugs like this. A history of breast cancer matters too, because risperidone raises prolactin.
Like all drugs of its kind, risperidone has a boxed warning. It is about a higher risk of death in older adults with dementia and psychosis. Risperidone can also make it harder to cool down. So drink enough fluids in hot weather. If you are pregnant or planning a pregnancy, talk it through with your prescriber.
Interactions to Know About
Carbamazepine and some other seizure drugs can lower risperidone levels. Fluoxetine and paroxetine can raise them. When one of these starts or stops, your prescriber may change the plan. Risperidone can also work against Parkinson's drugs that boost dopamine.
Alcohol and other sedating drugs add to sleepiness and dizziness. So can store-bought sleep aids and allergy pills. Blood pressure drugs can add to the drop in pressure when you stand. Keep a list of every medicine and supplement. Share it at every visit. Ask your pharmacist to check for problems each time something new is added.
Is Risperidone Right for You?
Only a full evaluation with a prescriber can tell you if Risperidone fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
SCHEDULE AN APPOINTMENT CALL (888) 457-8124
Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Cariprazine (Vraylar), atypical antipsychotic
- Clozapine (Clozaril), atypical antipsychotic
- Haloperidol (Haldol), typical (first-generation) antipsychotic
- Lurasidone (Latuda), atypical antipsychotic
- Olanzapine (Zyprexa), atypical antipsychotic
- Paliperidone (Invega), atypical antipsychotic
FAQ
Questions About Risperidone
What is Risperdal?
Risperdal is the brand name for risperidone. It is a newer type of antipsychotic. It treats schizophrenia, bipolar mania and irritability linked to autism. The generic has the same active medicine.
What is risperidone used for?
The FDA has approved risperidone for schizophrenia and for manic or mixed episodes of bipolar I disorder. It is also approved for irritability linked to autism. Some of these uses are approved for kids and teens. It is sometimes used off-label for other problems, and your prescriber explains the reason in your case.
What does risperidone do to prolactin, and why does it matter?
Risperidone can raise prolactin, a hormone tied to breast tissue and periods, more than most drugs in its class. This can cause breast tenderness or discharge, missed periods or sexual side effects. Tell your prescriber if you notice these, since a change in dose or medicine usually helps.
How fast does risperidone work?
Calmer moods and better sleep often show up within days. Core symptoms like voices, false beliefs or mania usually improve over two to six weeks of steady use. Keep taking it as prescribed even if change feels slow.
Does risperidone make you sleepy?
Yes, sleepiness is one of its most common side effects, especially early on. It often eases as your body adjusts. Avoid driving until you know how it affects you, and tell your prescriber if it gets in the way of your day.
Will risperidone make me gain weight?
Weight gain and a bigger appetite are common with risperidone. Your prescriber will track your weight, blood sugar and cholesterol over time. Regular activity and planned meals can help, and a change in plan is possible if weight gain becomes a problem.
Is there a long-acting shot instead of daily pills?
Yes. Risperidone comes in long-acting shots given on schedules from every two weeks to every two months, depending on the product. Many people find a shot easier than daily pills. Shots are given in person, so ask your prescriber how that would work for you.
Is risperidone used for anxiety or sleep?
Risperidone is not approved for anxiety or insomnia. Its side effects usually make other care a better first choice for those problems. Your prescriber can explain safer options if anxiety or sleep is the main concern.
Will risperidone change my personality?
No, the goal is the opposite. By quieting symptoms like paranoia, racing thoughts or severe irritability, risperidone helps the real you come through. If you feel flat or not like yourself, tell your prescriber so the plan can be adjusted.
Can I drink alcohol while taking risperidone?
It is best to avoid alcohol or keep it to a strict limit. Alcohol adds to the sleepiness and dizziness risperidone can cause and can worsen the symptoms being treated. Talk with your prescriber about what is safe for you.
What should I do if I miss a dose of risperidone?
Take it when you remember, unless it is almost time for the next dose. Then skip the missed one. Never take two doses at once to catch up.
Can I stop risperidone once I feel better?
Feeling better usually means the medicine is working, and stopping suddenly carries a high risk of relapse. How long you need it depends on your diagnosis and history. Always decide together with your prescriber, who can plan a slow, safe taper if it makes sense.