Risponz/Risponz 1/Risponz 2/Risponz 3 Dosage/Direction for Use

Risponz 1/Risponz 2/Risponz 3: Risperidone (Risponz) is a benzisoxazole antipsychotic reported to be an antagonist at dopamine D2 and serotonin (5‑HT2), adrenergic (α1 and α2), and histamine (H1) receptors. It is described as an atypical antipsychotic. It is given by mouth for the treatment of schizophrenia and other psychoses.
Risperidone (Risponz) may be given in 1 or 2 divided doses daily. The usual initial daily dose of Risperidone (Risponz) is 2 mg on the first day, 4 mg on second day and 6 mg on the third day. Further dosage adjustment may be needed and should generally be made at interval of not less than one week; usual maintenance doses are 4 to 8 mg daily. Extra pyramidal symptoms may be more likely with doses above 10 mg daily. The maximum recommended dose is 16 mg daily.
An initial dose of 0.5 mg twice daily slowly increased in steps of 0.5 mg twice daily to a dose of 1 to 2 mg twice daily suggested for the elderly and for patient with renal or hepatic impairment.
Schizophrenia꞉ The use of Risperidone (Risponz) for the management of schizophrenia has been reviewed. Features for which Risperidone (Risponz) has been promoted have included a relatively low incidence of extra pyramidal effect and efficacy against both positive and negative symptoms of schizophrenia. Most studies have compared Risperidone with haloperidol but, of these, some of the major studies have been criticized for potential methodological flaws and it is difficult to determine any difference in efficacy including effect on negative symptoms. The production of extra pyramidal effects appears to be dose dependent Risperidone (Risponz). Overall the incidence for Risperidone (Risponz) appears to be similar to that for placebo but at doses of more than 10 mg it appears to approach that associated with haloperidol. In the few comparative studies with other atypical antipsychotics Risperidone (Risponz) has appeared to be of similar efficacy to clozapine.
Dementia꞉ Risperidone (Risponz) has been used for the management of behavioural disturbances in patients with dementia. Although there have been anecdotal reports of efficacy in patient with Lewy body dementia other reports suggest that these patients are likely to be just as sensitive to Risperidone (Risponz) as to standard antipsychotic.
Risponz: Schizophrenia: Adults: Risperidone Oral Solution may be given once or twice daily. Patients should start with 2 mg/day risperidone. The dosage may be increased on the second day to 4 mg. Subsequently the dosage can be maintained unchanged, or further individualized, if needed. Most patients will benefit from daily doses between 4 and 8 mg. In some patients, a slower titration phase and a lower starting and maintenance dose may be appropriate. Doses above 10 mg/day have not demonstrated superior efficacy to lower doses and may cause increased incidence of extrapyramidal symptoms. Safety of doses above 16 mg/day has not been evaluated and are therefore not recommended.
Elderly: A starting dose of 0.5 mg twice daily is recommended. This dosage can be individually adjusted with 0.5 mg twice daily increments to 1 to 2 mg twice daily.
Pediatric population: Risperidone is not recommended for the use in children below age 18 with schizophrenia due to a lack of data on efficacy.
Manic episodes in bipolar disorder: Adults: Risperidone should be administered on a once daily schedule, starting with 2 mg risperidone. Dosage adjustments, if indicated, should occur at intervals of not less than 24 hours and in dosage increments of 1 mg per day. Risperidone can be administered in flexible doses over a range of 1 to 6 mg per day to optimize each patient's level of efficacy and tolerability. Daily doses over 6 mg risperidone have not been investigated in patients with manic episodes. As with all symptomatic treatments, the continued use of risperidone must be evaluated and justified on an on-going basis.
Elderly: A starting dose of 0.5 mg twice daily is recommended. This dosage can be individually adjusted with 0.5 mg twice daily increments to 1 to 2 mg twice daily. Since clinical experience in elderly is limited, caution should be exercised.
Pediatric population: Risperidone is not recommended for use in children below age 18 with bipolar mania due to a lack of data on efficacy.
Persistent aggression in patients with moderate to severe Alzheimer's dementia: A starting dose of 0.25 mg twice daily is recommended. This dosage can be individually adjusted by increments of 0.25 mg twice daily, not more frequently than every other day, if needed. The optimum dose is 0.5 mg twice daily for most patients. Some patients, however, may benefit from doses up to 1 mg twice daily.
Risperidone should not be used for more than 6 weeks in patients with persistent aggression in Alzheimer's dementia. During treatment, patients must be evaluated frequently and regularly, and the need for continuing treatment reassessed.
Conduct disorder: Children and adolescents from 5 to 18 years of age: For subjects ≥50 kg, a starting dose of 0.5 mg once daily is recommended. This dosage can be individually adjusted by increments of 0.5 mg once daily not more frequently than every other day, if needed. The optimum dose is 1 mg once daily for most patients. Some patients, however, may benefit from 0.5 mg once daily while others may require 1.5 mg once daily. For subjects <50 kg, a starting dose of 0.25 mg once daily is recommended. This dosage can be individually adjusted by increments of 0.25 mg once daily not more frequently than every other day, if needed. The optimum dose is 0.5 mg once daily for most patients. Some patients, however, may benefit from 0.25 mg once daily while others may require 0.75 mg once daily.
As with all symptomatic treatments, the continued use of risperidone must be evaluated and justified on an ongoing basis.
Risperidone is not recommended in children less than 5 years of age, as there is no experience in children less than 5 years of age with this disorder.
Renal and hepatic impairment: Patients with renal impairment have less ability to eliminate the active antipsychotic fraction than in adults with normal renal functions. Patients with impaired hepatic function have increases in plasma concentration of the free fraction of risperidone.
Irrespective of the indication, starting and consecutive dosing should be halved, and dose titration should be slower for patients with renal or hepatic impairment.
Risperidone should be used with caution in these groups of patients.
Method of administration: Risperidone is for oral use. Food does affect the absorption of risperidone.
Upon discontinuation, gradual withdrawal is advised. Acute withdrawal symptoms, including nausea, vomiting, sweating, and insomnia have very rarely been described after abrupt cessation of high doses of antipsychotic medicines. Recurrence of psychotic symptoms may also occur, and the emergence of involuntary movement disorders (such as akathisia, dystonia and dyskinesia) has been reported.
Switching from other antipsychotics: When medically appropriate, gradual discontinuation of the previous treatment while risperidone therapy is initiated is recommended. Also, if medically appropriate, when switching patients from depot antipsychotics, initiate risperidone therapy in place of next scheduled injection. The need for continuing existing anti-Parkinson medicines should be re-evaluated periodically.