Risperidone Adverse Effects

Neurological Effects

• Extrapyramidal symptoms (EPS) are the most prominent neurological concern, with risperidone causing more EPS than other atypical antipsychotics 1
• Risk of EPS increases significantly at doses >6 mg/24 hours 2, 1
• Acute dystonia, parkinsonism, akathisia, and tremor are documented 1
• Tardive dyskinesia has been reported in both adults and teenagers 1

Cardiovascular and Autonomic Effects

• Orthostatic hypotension is a common problem requiring monitoring 3, 1
• Dizziness and sedation are frequent 3, 1
• QTc prolongation of 0-5 ms (less than many other antipsychotics) 1

Metabolic and Endocrine Effects

• Extreme weight gain is the most common significant metabolic problem 1
• Hepatic transaminase elevations are a documented effect 1

Clinical Implications

• Concomitant medications that cause miosis (opioids, cholinergic agents, alpha-2 agonists) should be investigated if miosis is observed in a patient taking risperidone 2
• Underlying medical conditions affecting pupillary function should be investigated if miosis is observed in a patient taking risperidone 3
• Other substances or drug interactions should be investigated if miosis is observed in a patient taking risperidone 2