Risperidone

Risperidone is a medicine that helps to normalize the general mental state of the body.

Its use provides for the recovery of the central nervous system, relieves depression, hallucinations, stress and other unpleasant symptoms of neurological and mental abnormalities.

Widely used Risperidone was among patients with dementia and excessive aggression, delusional syndrome and schizophrenia. The mechanism of action of such drugs is aimed at arresting the symptoms of psychosis.

Clinical and pharmacological group

An antipsychotic agent (neuroleptic), a benzisoxazole derivative.

Terms of sale from pharmacies

It is possible to buy under the prescription of the doctor.

Price

How much does Risperidone cost in pharmacies? The average price in 2018 is at the level of210 rubles.

Composition and form of release

Risperidone is available in the form of a tablet for oral (oral) use, film-coated. They have a white color, a rounded shape and a biconvex surface.

In 1 tablet of risperidone 1 mg, 2 mg or 4 mg.

instagram viewer

Povidone, starch, calcium hydrophosphate dihydrate, magnesium stearate, cellulose as auxiliary substances.

Tablets are packaged in a contour squamous package of 10 pieces. The cardboard pack contains 2 contour cell packs (20 tablets) and instructions for the use of the drug.

pharmachologic effect

Risperidone is an atypical neuroleptic that has an anxiolytic effect. Refers to a group of drugs of antipsychic type.

The active substance of the drug causes selective blocking of serotonin 5-HT2 and dopamine D2 receptors. It also binds to alpha1 and alpha2-adrenergic receptors. Has no effect on cholinergic receptors. Despite the fact that the main constituent substance of the drug causes the blocking of D2-receptors, it does not render The inhibitory effect on motor activity in comparison with other antipsychotics is the least likely to cause a condition catalepsy.

Antipsychotic action is associated with blocking of D2 receptors, sedative effect is associated with blocking adrenoreceptors of the brainstem of the brain, and anti-emetic - with the blocking of D2-receptors responsible for the vomiting Centre. As a result of the use of the drug, hallucinations, automatism, aggression, delirium are eliminated. Depending on the dosage can cause an increase in the level of prolactin in the blood.

Pharmacokinetics

After oral administration, complete absorption takes place, the maximum concentration in the blood plasma is reached after 1-2 hours. Food intake for absorption of the drug is not affected. Absolute bioavailability of risperidone is 70%.

The substance is quickly distributed in the body. The volume of distribution is from 1 to 2 l / kg. Plasma binds to albumin and alpha1-glycoprotein. Risperidone binds 90% to plasma proteins, 9-hydroxyrisperidone (the main active metabolite of risperidone) - by 77%.

In most patients, the equilibrium concentration of risperidone in the body is reached within 24 hours, 9-hydroxyrisperidone - after 4-5 days. The plasma concentration of Risperidone in the blood is proportional to the dose received (within therapeutic doses).

Indications for use

The instructions for use indicate a number of diseases and conditions that are treated with tablets Risperidone. It:

acute and chronic schizophrenia, psychotic states with productive signs;
behavioral disorders in adults and adolescents with low intelligence (when the main symptoms are impulsiveness, aggressiveness, autoaggression);
unstable emotional reactions in mental pathologies;
mood correction in the treatment of mania;
behavioral disorder in patients with dementia (anger, aggressiveness, delirium, physical abuse, agitation).

Contraindications

Absolute:

Parkinson's disease;
age up to 15 years;
prostate adenoma;
severe liver and kidney disease;
hypersensitivity to the drug;
lactation;
glaucoma.

With caution should be prescribed for brain tumors, chronic heart failure, lengthening of the QT interval, myocardial infarction, convulsions, dehydration, pregnancy, intestinal obstruction.

Intended use for pregnancy and lactation

During pregnancy, the drug intake can be prescribed only by a doctor and if urgently needed, only when the expected benefit to the mother will be higher than the expected risk for the child.

Since the constituent components of the medication fall into the composition of breast milk, it is best to stop breastfeeding during the treatment period.

Dosage and route of administration

As indicated in the instructions for use, the dosage regimen of Risperidone is strictly individual.

When administered orally, the initial dose for adults is 0.25-2 mg / day, on the second day - 4 mg / day. Then the dose can either be kept at the same level, or, if necessary, corrected. Usually the optimal therapeutic dose, depending on the indications, is in the range of 0.5-6 mg / day. In some cases, a slower dose increase and lower initial and maintenance doses may be justified.

In schizophrenia for elderly patients, as well as with concomitant diseases of the liver and kidneys, an initial dose of 500 μg 2 times / day is recommended. If necessary, the dose can be increased to 1-2 mg 2 times / day.

Maximum dose: when risperidone is administered at a dose of more than 10 mg / day, there is no increase in efficacy compared with lower doses, but the risk of developing extrapyramidal symptoms increases. The safety of the use of risperidone in doses greater than 16 mg / day has not been studied, therefore further excess of the dose is not allowed.

Does risperidone cause addiction and withdrawal symptoms?

With prolonged use of the drug may develop dependence on it. If you stop abruptly taking risperidone, the patient may develop withdrawal syndrome. The essence of it is that all the symptoms that existed before the beginning of treatment and disappeared after taking the medication, are returned and significantly strengthened. The patient may complain of insomnia, psychoemotional and motor excitement, schizophrenia patients may experience hallucinations, delusions, aggressive behavior, and so on.

To prevent the development of the described phenomena, the drug should be withdrawn slowly, gradually reducing the daily dose by - 5 mg every 3 to 6 days. In the case of using risperidone in the form of a suspension of prolonged action, each subsequent dose should be reduced by 10 mg.

Side effect

Against the background of taking Risperidone tablets, it is possible to develop side effects and negative reactions from various organs and systems, they include:

Sexual system - erectile dysfunction, premature ejaculation or its delay, violations of orgasm.
The cardiovascular system is a marked decrease in blood pressure at the moment of the person's transition from the horizontal position to vertical (orthostatic hypotension), increased blood pressure (arterial hypertension), increased heart rate (tachycardia).
The digestive system - nausea, periodic vomiting, discomfort and pain in the area of the projection of the stomach (epigastrium), bloating, unstable stool, increased level of enzymes of hepatic transaminases in the blood, which is evidence of damage to liver cells (hepatocytes).
Endocrine system - women can develop galactorrhea (the appearance of breast milk is not related to the period lactation), menstrual irregularity, weight gain, in men - gynecomastia (increased dairy glands).
The nervous system is a bad dream (insomnia), a sense of anxiety, a periodic headache. Less often, drowsiness, fatigue, dizziness, decreased concentration of attention, extrapyramidal disorders (tremor of hands, increased saliva formation), impaired clarity of the visual perception. In patients with schizophrenia on the background of taking Risperidone tablets, thermoregulation disorders and convulsive seizures may occur.
Blood and red bone marrow - a small decrease in the number of neutrophils (neutropenia) and platelets (thrombocytopenia) in the blood.
Allergic reactions - allergic inflammation of the nasal mucosa (allergic rhinitis), the appearance of a rash on the skin, its itching, characteristic changes resembling a nettle burn (urticaria).

Also, while taking Risperidone tablets, urinary retention is possible. In the case of negative reactions, the doctor decides whether to cancel the drug individually.

Overdose

If the amount of the drug is exceeded, an overdose occurs, which is manifested by extrapyramidal disorders, palpitations, hypotension, excessive drowsiness and sedation. Treatment involves washing the stomach, taking laxatives and sorbents.

If the patient is unconscious, then intubation is indicated. The patient needs to do an ECG, since arrhythmias are possible. The use of anticholinergic drugs is indicated in the occurrence of acute extrapyramidal disorders.

special instructions

Before you start using the drug, read the special instructions:

In the case of the development of the NSA, all antipsychotics, including risperidone, should be discontinued.
Caution should be used risperidone in patients with Parkinson's disease, because theoretically possible deterioration of the disease.
Risperidone should be used with caution in combination with other drugs of central action.
With the withdrawal of carbamazepine and other inducers of hepatic enzymes, the dose of risperidone should be reviewed and, if necessary, reduced.
During the period of treatment, patients should be advised to refrain from overeating due to the possibility of weight gain.
Data on the safety of risperidone in children under the age of 15 years are not available.
It is known that classical antipsychotics reduce the threshold of convulsive readiness. Given this, risperidone is recommended with caution in patients with epilepsy.
The risk of developing orthostatic hypotension is especially elevated in the initial period of dose selection. If hypotension occurs, consider lowering the dose.
Use with caution in patients with cardiovascular disease (including heart failure, myocardial infarction, cardiac muscle conduction abnormalities), as well as during dehydration, hypovolemia or cerebrovascular violations. In this category of patients, the dose should be increased gradually.
When using drugs that have the properties of antagonists of dopamine receptors, the occurrence Late dyskinesia characterized by involuntary rhythmic movements (predominantly of the tongue and / or person). There are reports that the occurrence of extrapyramidal symptoms is a risk factor for the development of tardive dyskinesia. Risperidone causes the appearance of extrapyramidal symptoms to a lesser extent than the classical antipsychotics. When symptoms of tardive dyskinesia appear, consideration should be given to the abolition of all antipsychotics.

In the period of treatment, before clarifying individual sensitivity to risperidone, patients should avoid driving and other activities that require a high concentration of attention and speed of psychomotor reactions.

Interaction with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

When used simultaneously with carbamazepine, the concentration of risperidone in the blood plasma is significantly reduced.
With simultaneous use, risperidone reduces the effects of levodopa and other dopamine receptor agonists.
With simultaneous use with fluoxetine, an increase in the concentration of risperidone in the blood plasma is possible.
With the simultaneous use of inducers of microsomal liver enzymes, a decrease in the concentration of risperidone in the blood plasma is possible.
With simultaneous use with phenothiazine derivatives, tricyclic antidepressants and beta-adrenoblockers, an increase in the concentration of risperidone in the blood plasma is possible.

Reviews

We offer to familiarize with reviews of people who used the drug Risperidone:

Marina. At the beginning of the year I was put in a psychiatric hospital. There I got acquainted with the wonderful medicine "Risperidon". I was given it throughout the treatment. I can say with confidence that he helped me a lot. Hallucinations have passed, attacks of aggression, too. I am amazed by the wonderful properties of this drug and I can say with confidence that it really works.
Christina. Several months ago began to notice behind itself such unpleasant condition, as occurrence, any voices. It seems that she never suffered from a mental disorder, but once again such an unpleasant problem. Quickly went to a psychiatrist. After the examination, it turned out that it was on the nerves, he prescribed me to take Risperidone. I drank it according to the dosage. At first, there were problems with eyesight, and the head was very sick, but then it normalized and the voices disappeared.
Maksim. My profession requires stress resistance, but at one point I experienced a breakdown in the nervous system. He became very irritable and aggressive. After a medical examination, a neuroleptic was prescribed. The first week of treatment was accompanied by a disorder of the stomach and loss of appetite. Later all was adjusted. Mental health is normal.

Doctors (mainly psychiatrists and neurologists) consider the drug to be quite effective in treating the symptoms of schizophrenia and other psychiatric disorders, manifested by similar symptoms.

To the advantages of the medicine experts attribute high efficiency, rapid onset of action, and the absence of many side effects typical of typical neuroleptics. Moreover, the variety of release forms allows you to select the most effective dose and route of administration of the drug for each particular patient. Particular attention should be paid to powders for the preparation of suspensions for intramuscular administration, which have a prolonged (prolonged) effect. Use them is fairly simple, and the effect of one injection is maintained for 2 weeks, which eliminates the need to take the drug inside every day.

To the shortcomings of risperidone, doctors attribute its high cost (especially the forms intended for injections), which sometimes becomes a serious problem in prescribing the drug.

Analogues

Medicament Risperidone is not suitable for every patient, which depends on the form of a particular disease, its course and individual characteristics of the organism.

Tablets can be replaced with analog medicines:

Rileptide - a drug that is used in the treatment of mental illness. Produced in the form of tablets, solution for ingestion, powder (from which suspensions are prepared for intramuscular injection).
Neuroleptic Rispedal is available in tablets of 1, 2, 3 mg. It is prescribed for schizophrenia, affective and behavioral disorders. Dosage is calculated individually.
Rispen - neuroleptic agent is produced in tablets of different colors (white - 1 mg, pink - 2 mg, yellow - 3 mg, green - 4 mg). Do not take if you have a sensitivity to risperidone.
Risperidone Organica is a medicament that is effective for the therapy of a number of mental illnesses and conditions (for example, acute and chronic schizophrenia, behavioral disorders, mania in bipolar disorders).

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

The shelf life of the Risperidone tablets is 2 years. The drug should be stored in a dark, dry place inaccessible to children at an air temperature of no more than + 25 ° C.

How to choose probiotics for the intestine: a list of drugs.

Effective and inexpensive cough syrups for children and adults.

Modern non-steroidal anti-inflammatory drugs.

Review of tablets from the increased pressure of the new generation.

Antiviral drugs are inexpensive and effective.