Risperidone is an atypical antipsychotic used to treat schizophrenia, bipolar mania, and irritability in autism. This article covers its uses, dosing guidelines, and potential side effects.

Risperidone is a second‑generation (atypical) antipsychotic prescribed for schizophrenia, acute manic or mixed episodes of bipolar I disorder, and irritability associated with autistic disorder. It works primarily by blocking dopamine D2 and serotonin 5‑HT2A receptors in the brain, helping to rebalance neurotransmitters linked to mood, thought, and behavior.

Approved Uses and Benefits
In schizophrenia, risperidone reduces hallucinations, delusions, and disorganized thinking
For bipolar mania, it alleviates elevated mood, excessive energy, and irritability
In children with autism, it decreases aggression, self‑injury, and severe tantrums

Dosing Guidelines
Adults typically start at 1 mg twice daily or 2 mg once daily, titrating by 1 mg every 1–2 days to an effective range of 4–6 mg daily
Pediatric dosing for autism‑related irritability begins at 0.25 mg (ages 5–16) once or twice daily, increased gradually
Take with or without food; consistent timing helps maintain stable blood levels

Common Side Effects
Sleepiness, fatigue, and dizziness often occur early but may diminish over weeks
Weight gain and increased appetite require monitoring of diet and exercise
Extrapyramidal symptoms—tremor, rigidity, or akathisia—can emerge, especially at higher doses
Hyperprolactinemia may cause menstrual irregularities or breast changes

Monitoring and Safety
Baseline metabolic panel, lipid profile, and weight
Periodic checks of fasting glucose, lipids, and prolactin
Watch for signs of movement disorders; consider dose adjustment or alternative therapy if needed
Avoid alcohol and use caution with other central nervous system depressants

Tapering and Discontinuation
Abrupt stop can cause withdrawal symptoms—insomnia, nausea, return of psychosis
Gradually reduce dose over weeks under medical supervision

When used and monitored properly, risperidone provides significant symptom relief across multiple psychiatric conditions. Work closely with your healthcare provider to optimize dosing, manage side effects, and ensure the safest, most effective therapy.