Risperidone Dosage Adjustment for Persistent Auditory Hallucinations

Monitoring and Dose Adjustment

If extrapyramidal symptoms (EPS) occur, consider dose reduction rather than adding anticholinergic medication, as recommended by the American Academy of Family Physicians 1

For persistent auditory hallucinations, the therapeutic target is often higher than for other symptoms, with studies showing that risperidone can significantly reduce hallucinations, reducing distressing dreams/hallucinations from 38% to 19% after 6 weeks of treatment with doses ranging from 1-3 mg (mean 2.3 mg), according to the American Academy of Sleep Medicine 2, 3
Failure to recognize that non-verbal auditory hallucinations may require higher doses than the current 3 mg can lead to inadequate treatment, as noted by the American Academy of Sleep Medicine 2, 3