Risperdal (risperidone): what it treats and what to watch for

Risperdal (generic: risperidone) is a commonly prescribed antipsychotic. People use it for schizophrenia, bipolar mania, and irritability linked to autism. It can calm hallucinations, reduce severe agitation, and steady mood swings. That benefit comes with trade-offs, so knowing how it works and what to monitor makes a big difference.

Risperidone changes brain chemistry by blocking certain dopamine and serotonin receptors. That helps reduce psychotic symptoms and mood instability. It comes as pills, an orally disintegrating tablet, a liquid, and a long-acting injection (Risperdal Consta). Which form you get depends on your needs and how steady you are taking medication.

Uses and typical dosing

Doctors prescribe Risperdal for: schizophrenia in adults and teens, acute manic episodes in bipolar disorder, and irritability in children and adolescents with autism. Doses vary a lot by condition and age.

Typical adult dosing starts low to avoid side effects—often 1 mg twice daily or 2 mg once daily—then slowly increases. For schizophrenia, maintenance often falls between 2–6 mg daily. For bipolar mania, a similar range is common. Children and teens use lower doses; doctors adjust by weight and response. The long-acting injection is given every two weeks and helps when daily pills are missed.

Side effects, risks and practical safety tips

Common side effects include drowsiness, weight gain, dry mouth, and constipation. Some people notice shakiness or stiffness (extrapyramidal symptoms). Risperidone can raise prolactin levels, which may cause breast milk production, missed periods, or sexual side effects.

There are serious risks to know: it can increase blood sugar and cholesterol, so diabetes or heart risk needs checking. Older adults with dementia-related psychosis have a higher risk of stroke and death on antipsychotics—Risperdal carries a black box warning for this. Always tell your prescriber if you have heart disease, diabetes, or a history of strokes.

Drug interactions matter. Certain antidepressants (like fluoxetine), some antifungals, and strong CYP2D6 inhibitors can raise risperidone levels and side effects. Alcohol and other sedatives increase drowsiness. Don’t stop suddenly—withdrawal or return of symptoms can happen.

Practical tips: take the pill at the same time daily; if it makes you sleepy, try night dosing. Track weight, appetite, sleep, and any movement changes for the first few months. Ask your doctor for baseline labs—weight, fasting glucose, and lipids—and repeat checks while you take it. If you feel unusually restless, have muscle stiffness, or notice breast changes, call your provider quickly.

Risperdal can help many people, but it’s not one-size-fits-all. Talk openly with your prescriber about goals, expected benefits, and which side effects you’re willing to tolerate. Keep a symptom diary and schedule regular follow-ups—those small steps make treatment safer and more effective.