Risperidone

A second generation, or atypical, antipsychotic helps to adjust the levels of dopamine and other chemicals available in your brain to calm it down.

Tell your doctor or pharmacist before you take risperidone if you have any of these conditions

You need to talk to your doctor or pharmacist if any of the following apply to you:

• If you have any heart problems
• If you have epilepsy
• If you have diabetes
• If you have had a blood clot, or anyone in your family has had one
• If you have ever had unusual movements of your tongue, mouth or face
• If you have kidney or liver problems
• If you or someone in your family has had a stroke, or is at risk of a stroke
• You have ever had a condition known as Neuroleptic Malignant Syndrome (NMS) whose symptoms include high temperature, muscle stiffness or sweating

• If you have a condition called porphyria (ask your doctor – if you have it, it should be on your records)

• If you are a man who has ever had an erection that lasted for more than a few hours and was very painful (priapism)

Risperidone has possible side effects, and some of these are rare but serious

Go to a doctor or hospital straight away if you get any of the following symptoms:

• swelling, pain, and redness in the leg, which may lead to chest pain and difficulty breathing. This might be a blood clot.
• feeling a sudden change in your mental state, or difficulty with your memory
• sudden weakness or numbness of your face, arms or legs, especially on one side, or slurred speech, even for a short period of time. This may be a stroke.
• fever, muscle stiffness, sweating or a loss of consciousness (a problem called “Neuroleptic Malignant Syndrome”)
• if you get a painful erection that lasts more than a couple of hours in men (priapism)
• movements of the tongue, mouth and face that you cannot control – this could be a condition called ‘tardive dyskinesia’
• any type of chest infection (antipsychotics have been linked with a greater risk of getting pneumonia, a very serious condition of your lungs. This can happen even when you first start taking it)
• fits (convulsions)

Some side-effects that do appear should get better after a few days. If they do not, you should go back to your doctor

Not everyone will experience side effects with quetiapine. Some of the more common side effects are listed at the bottom of this page. If you are experiencing a problem that might be a side effect, but that is not listed here, please take a look at the patient information leaflet that was in the medicine packet or speak to your pharmacist or doctor. If you think you have a side effect that has not got better within a few days go back to your doctor.

There are many possible side-effects when you start taking risperidone. Some people will have no side-effects and some people will have a few – it is hard to say which you will get as everyone is different. Most will get better after a few days, but if they do not and they are affecting your life, you should go back to the doctor.

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.

Young people were more likely than adults to get some side-effects

Young people and children aged 5-17 were more likely than adults to get the following side-effects:

• feeling tired, sleepy, or less focused
• headache
• feeling hungry and eating more (greater appetite)
• being sick (vomiting)
• getting cold symptoms like a blocked nose and cough
• pain in your gut (abdomen)
• fever
• dizziness and shaking
• loose poo (diarrhoea) and less control over when you wee (incontinence)
• Again, speak to your pharmacist or doctor if you think you're having side-effects from risperidone

Risperidone can interact with some other medicines and drugs

Do not take risperidone if you take:

• medicines that work on your brain such as to help you calm down (benzodiazepines) some medicines for pain (opiates) - risperidone may make you more sleepy with them
• medicines for allergy (some antihistamines) - risperidone may make you more sleepy with them
• medicines that may change the electrical activity of your heart, such as medicines for malaria, heart rhythm problems, allergies (anti-histamines), some antidepressants or other medicines for other mental health conditions
• medicines that cause a slow heartbeat
• medicines that cause low blood potassium (such as certain water tablets (diuretics))
• medicines to treat high blood pressure - risperidone can also lower your blood pressure
• medicines for Parkinson's disease (such as levodopa)
• water tablets (diuretics) used for heart problems or swelling of parts of your body due to a build up of too much fluid (such as furosemide or chlorothiazide)

If you have any further questions about this you should speak to your doctor or pharmacist.

Always talk to the doctor if you are taking other medicines. Tell the pharmacist you are taking risperidone if you buy medicines (including things you put on your skin) for common illnesses.

The effects of some other medicines can be changed when you take them together with risperidone

Other medicines may cause problems when taken with risperidone.

These medicines make you drowsy, and adding risperidone can make the tiredness worse:

• medicines that work on your brain, such as those to help you feel calm (like benzodiazepines)
• some medicines for pain (opiates like codeine or morphine)
• medicines for allergy (some antihistamines)

These medicines can reduce the effect of the risperidone, so you might need a higher dose of risperidone:

• Rifampicin (a medicine for treating some infections)
• Carbamazepine and phenytoin (medicines for epilepsy)
• Phenobarbital (a sedative and anticonvulsant)

And these medicines can increase the effects of the risperidone, so you might need a lower dose of risperidone:

• Quinidine (an older medicine used for certain types of heart disease)
• Antidepressants such as the SSRIs paroxetine and fluoxetine, and tricyclic antidepressants
• Medicines known as beta blockers (used to treat high blood pressure and sometimes to treat migraine or anxiety)
• Phenothiazines (other medicines used to treat psychosis or to help people to feel calm)
• Cimetidine or ranitidine (medicines used for stomach ulcers or too much acid in your stomach).

• Azole antifungal medicines.

If you start or stop one of these medicines you might need a different dose of risperidone.

Get your weight and blood checked regularly when you take risperidone

• You will have your weight checked, and have some blood tests, when you start taking risperidone.
• You should then have your weight, blood sugar, blood fats, blood pressure and pulse measured regularly during early treatment, then at least 6 monthly or annually thereafter depending on your age.
• You should also have your blood sugar tested when you start, after 4-6 months, and every year after that.
• The doctor might also check your heart with an electrocardiogram ECG.
• They might also check your height and development, and whether a young woman’s periods are regular.
• It is very important to go for these checks when you are asked to do so.

The doctors should repeat these every year you’re taking risperidone. If you haven’t had these checked for a while, talk to your doctor to make sure they’re up to date.

Risperidone use has been linked to high blood sugar and diabetes in some young people

• Some studies have shown a risk of developing diabetes among young people who have a family history of diabetes.
• This could be linked to putting on weight.
• Watch out for any early signs of diabetes: wanting to drink a lot, going for a wee a lot, feeling more hungry, feeling weak

• If you already have diabetes, taking risperidone may affect your blood sugar levels.
• Talk to your doctor, and check your blood glucose levels regularly.

• You may have to increase the medication you use for your diabetes.

Risperidone does not mix well with street drugs

• Some street drugs can increase levels of dopamine in the brain (e.g. cocaine, cannabis, ecstasy). As antipsychotics block the effects of dopamine, the “high” from street drugs may not be as “high” as before. You may therefore be tempted to increase the dose of your street drug to make up for it, but this could be dangerous.
• Some street drugs can make you feel sleepy and this could be made worse with risperidone.
• There are many other street drugs but we don’t know what effect taking them with risperidone will have.

Stopping the medication causes the balance of chemicals in the brain to alter

•  When you start taking an antipsychotic, your brain adjusts to having  lower of dopamine around.
• If you stop taking the antipsychotic suddenly, the balance starts to change again and your brain can take a while to adapt to this change. You could get your old symptoms back. You could get some symptoms from the change which are called withdrawal symptoms although these are mild and rare with risperidone.

Stopping this medicine quickly, or reducing the dose too much at once, may cause your old symptoms to come back

• You will probably get your old symptoms back if you stop risperidone suddenly.

You can stop taking it safely with your doctor’s help

• If you are thinking of stopping or want to stop, talk to your doctor and they can help.
• They will reduce and stop the risperdone slowly so that any problems (like your old symptoms coming back) can be picked up quickly.
• It is better to agree stopping with a doctor who will reduce you gradually. This will be done over a few weeks.