Risperidone
Active ingredient
Risperidone is a prescription drug from the group of atypical neuroleptics. In Germany it is i.a. sold under the trade name Risperdal®.
It is called atypical because with risperidone, compared to other neuroleptics, the side effects on certain nerve tracts in the spinal cord (extrapyramidal motor system) should be lower.
In addition, memory performance and the ability to concentrate should be higher during therapy with atypical neuroleptics than with therapy with classic neuroleptics. As a result, the action profile of atypical neuroleptics is sometimes more favorable.
scope of application
Risperidone is used to treat psychiatric illness used.
The focus is on the treatment of the severe and chronic schizophrenia, in which those affected i.a. on Hallucinations and Paranoia Suffer.
It also shows effects in the therapy of pathological excess (mania), at Obsessive-compulsive illness and post-traumatic stress disorder.
Risperidone is approved for that Short term treatment (a maximum of 6 weeks) of people with Alzheimer's dementiawho show a very aggressive behavior towards themselves and their environment. Also at Children with behavioral disorders (from at least 5 years) Risperidone can be used for short-term treatment.
Mode of action
Risperidone acts on special Receptors in the brainthat are normally caused by messenger substances (Neurotransmitters) are aroused and are responsible for the mental state and vegetative functions.
Risperidone works primarily inhibiting on Serotonin receptors. These receptors are particularly responsible for psychological dysregulations in the brain.
Risperidone can by attacking the receptors reduce their effectiveness and the attenuate psychological symptoms.
Risperidone also works inhibiting on Dopamine receptors. Dopamine is a messenger substance, among other things Happiness mediated and that Reward center activated.
But it is too much dopamine present in the brain Psychosis and schizophrenia arise.
Risperidone helps keep dopamine levels back on normal level to bring and thereby reduce the psychological malfunctions. Ultimately blocked Risperidone as well Adrenoceptors and Histamine receptors. Thereby it acts i.a. antihypertensive. Risperidone has a positive effect on the self-control of the patient, aggressive behavior is reduced.
dosage
The dosage of the drug is determined by the attending physician. Usually the Starting dose at 2mg risperidone per day. This can be increased gradually.
The most patients be with a Daily dose of 4-6mg Risperidone treated. The dose can be divided into one or two times a day. His full effect Risperidone only unfolds after about two weeks Intake time. This is especially important for people with a tendency to endanger themselves.
Instructions for use
It can be taken with or without a meal with a glass of water. Other beverages (e.g. tea) are not recommended for taking risperidone.
Patients with swallowing disorders can also use the medicine injection or as Orodispersible tablet administered.
The intake should always regularly respectively. Unauthorized discontinuation of the drug or unauthorized changes to the dose should be avoided, as this can lead to a rapid deterioration in the state of health. Also should be from Alcohol consumption while taking risperidone apart become.
Contraindications
Risperidone may not at existing Hyperprolactinemiai.e. be used if the level of the hormone prolactin in the blood is increased. This prolactin excess can, for example, by a Pituitary gland tumor (Pituitary gland) (so-called prolactinoma).
Prolactin controls, among other things the Milk penetration in the female breast in the Lactation (Lactation) and ensures the maturation of the mammary gland tissue.
Dopamine regulates and inhibits the release of prolactin so that not too much of it gets into the circulation. Since risperidone lowers the effect of dopamine, this would mean that the prolactin level could increase further, which would not be an advantage if the levels were already too high.
Take special care when taking risperidone is advisable Parkinson's disease and heavy Cardiovascular diseases. These diseases could get worse with risperidone therapy.
Also at Liver and kidney dysfunction the indication of risperidone therapy must be checked separately. In any case, with these diseases there is one Reduction in dose indicated, as the drug remains in the body longer with impaired liver and kidney performance.
Use in special patient groups
Children and young people
Children and young people with schizophrenia or mania should not treated with risperidone up to the age of 18 become.
At Behavior disorders can risperidone from the age of 5 can be used, but only in very large lower dosage (0.5mg), which can only be increased slowly and in small steps.
Any other causes of the child's disturbed behavior must be excluded beforehand.
Elderly patients
At elderly patientswho are taking risperidone is special caution required. If there is a dementia elevated under risperidone therapy risk for one stroke. If the dementia already by an earlier one stroke should risperidone not applied become.
Generally risperidone is used in elderly patients lower dosethan in younger patients since the Metabolism of the drug in old age slowed down is. The usual dose ranges from 0.5-2mg risperidone daily.
Pregnancy / lactation
Risperidone should be used during pregnancy and breastfeeding not applied become.
In cases in which therapy with risperidone appears to be absolutely necessary, the attending physician can decide whether the medicine can be taken safely. At Womenthat are in the last three months pregnancy Risperidone taken had, became part Side effects, such as breathing difficulties, muscle tremors, restlessness, and problems with breastfeeding.
Driving with risperidone
Through risperidone you can fatigue, dizziness and Visual disturbances be evoked. The ability to drive and operate machines should be clarified with the attending physician.
Side effects
The most common side effect (more than 1 in 10 people treated) of risperidone is the so-called Parkinsonism.
In doing so, the people develop Symptomswho the Parkinson's disease same. For example, there may be difficulties walking (small, tripping steps, stiffness of the muscles, increased saliva secretion and slowed, difficult movements.
Just as often headaches and insomnia occur.
Frequently (more than 1 in 100 people treated) it can too Weight gain, Increase in the hormone prolactin in blood, dizziness, Anxiety and Gastrointestinal complaints (Nausea, Vomit, constipation, Diarrhea).
Furthermore, the occurrence of sleepiness, sexual disorders and Poor circulatory regulation observed. Additional side effects of risperidone can be found in the package leaflet that came with the medication.
In therapy with risperidone there is many side effectsthat heaped in the Start time occur and lead many patients to want to stop taking the drug straight away.
It should be noted that the side effects may subside after getting used to the drug. Nevertheless, the attending physician should closely monitor any side effects and decide whether further treatment with risperidone is indicated.
Interactions
Risperidone can interact with many other drugs. Therefore, special attention should be paid to which drugs can be combined with risperidone.
As particularly risky the combination of risperidone applies with diuretic drugs (Diuretics) in the elderly. In such cases, an increased incidence of strokes and increased mortality was noted.
Become at the same time as risperidone Antidepressants or Beta blockers (antihypertensive agents) used, it can be used for mutual Effect enhancement these drugs come.
alcohol, Sedatives and Anesthetics also show one enhanced effect under risperidone therapy.
Some sedatives (e.g. Barbiturates) accelerate the breakdown of risperidone. This reduces its effectiveness.
Is risperidone used in parallel with therapy for Parkinson's disease Dopamine agonists Taken (dopamine-enhancing drugs) also reduces its effects.
Overdosing / underdosing and stopping use
Should be a Ingestion of risperidone to forget is normal with taking the next one to continue at the usual time of taking.
Should too much risperidone is taken immediately To see a doctor, as it can lead to a dangerous drop in blood pressure, irregular heartbeat or seizures.
Should the therapy with risperidone completed it is advisable to taper off the drug, i.e. a lslow reduction the dose over a longer period of time. At abrupt withdrawal Risperidone occur more often Side effects on, such as. Nausea and vomiting, sleep disorders, restlessness and increased sweating.
A recurrence of the psychotic symptoms cannot be ruled out either.
