CONCLUSION: This study suggests that oral risperidone may be a safe option for acute agitation in patients presenting to the ED with alcohol intoxication. Copyright © 2017 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]

• Weight Gain

  The LAIR treatment was terminated in 26.2% of the patients, due to weight-gain, dystonia, and galactorrhea. [ncbi.nlm.nih.gov]

  Monitoring should be guided individually based on weight gain and other risk factors. [oadoi.org]

• Pain

  Two months after switching from risperidone to paliperidone, his eye blinking, light sensitivity, jaw pain, and trismus gradually improved, although the dysarthria persisted. [ncbi.nlm.nih.gov]

  Postural dizziness ( Pruritus ( Acne (1-2%) Hyperprolactinemia ( Sexual dysfunction ( Xerostomia (7-10%) ER suspension Sedation (7-7.7%) Pain in extremity (0.9-7.7%) Constipation (7-7/7%) Anxiety (2.6-6.8%) Akathisia (2.6-6.8%) Back pain (3.5-6.8%) Musculoskeletal [reference.medscape.com]

  Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination. [mayoclinic.org]

  Oxycodone Oxycodone is indicated for the treatment of moderate to severe pain.[Label] There is also an extended release formulation indicated for chronic moderate to severe pain requiring continuous opioid analgesics for... [drugbank.ca]

• Chills

  Within 15 minutes of the first paliperidone injection, the patient developed flushing of the face, neck, and head, and he soon developed chills, rigors, and difficulty breathing; after treatment to resolve those symptoms, oral risperidone was restarted [ncbi.nlm.nih.gov]

  […] glaucoma, visual acuity reduced Gastrointestinal disorders: Dysphagia, fecaloma, fecal incontinence, gastritis, lip swelling, cheilitis, aptyalism General disorders: Thirst, gait disturbance, chest pain, influenza-like illness, pitting edema, edema, chills [reference.medscape.com]

  […] missed menstrual periods; severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out; low white blood cells - sudden weakness or ill feeling, fever, chills [drugs.com]

  Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination. [mayoclinic.org]

• Epilepsy

  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 [headmeds.org.uk]

  Inform your Doctor if: you had negative reactions to this drug in the past. if you have a history of asthma, breast cancer, epilepsy, heart rhythm disturbances, liver /kidney disease, Parkinson's disease, seizures, or Tardive Dyskinesia. if you are taking [psyweb.com]

  People with a history of seizures, eg epilepsy. People with conditions that increase the risk of epilepsy or convulsions, eg brain damage or withdrawal from alcohol. Parkinson's disease. [netdoctor.co.uk]

  Anti-fungals like itraconazole and ketoconazole medicines to treat Parkinson's disease or a tremor medicines to treat epilepsy medicines to treat depression, panic disorder, anxiety or obsessive-compulsive disorder. [news-medical.net]

• Asymptomatic

  At follow-up after 1 month, she was found asymptomatic on clinical assessment (MSE). No psychiatric rating scale was used. She felt better with amisulpride in comparison to risperidone. [jmhhb.org]

  17.7 ng/mL after 1 year of treatment and from 7.4 ng/mL to 24.9 ng/mL after 2 years of treatment. 13 The authors opined that prolactin levels may be influenced by “genetic differences that influence prolactin metabolism and D2 receptor density.” 13 Asymptomatic [healio.com]

  In addition, there is no knowledge of the prescribed indications, especially with risperidone being the only atypical antipsychotic drug currently licensed for asymptomatic treatment in patients with dementia. [bmcmedicine.biomedcentral.com]

• Nausea

  Correspondingly, dysregulation of the dopaminergic system has been implicated in diseases such as schizophrenia, Parkinson's disease, depression, attention deficit hyperactivity disorder, and nausea and vomiting. [ncbi.nlm.nih.gov]

  The most common adverse reactions that were associated with discontinuation from clinical trials (causing discontinuation in >1% of adults and/or >2% of pediatrics) were nausea, somnolence, sedation, vomiting, dizziness, and akathisia” (see package insert [aap.org]

  You can take risperidone with or without food, but if it makes you feel sick (nausea), try taking it with food. If you forget to take your dose, take it as soon as you remember that day. [healthnavigator.org.nz]

  Withdrawal symptoms may include dizziness, nausea, sleepiness, and the return of symptoms of schizophrenia. [psycom.net]

  Your pharmacist may be able to advise you on managing side effects. agitation anxiety constipation difficulty sleeping and staying asleep dizziness diarrhea dry mouth headache increased amount of saliva indigestion joint aches muscle stiffness nausea [chealth.canoe.com]

• Fecal Incontinence

  […] oculogyration, ocular hyperemia, eye discharge, conjunctivitis, eye rolling, eyelid edema, eye swelling, eyelid margin crusting, dry eye, lacrimation increased, photophobia, glaucoma, visual acuity reduced Gastrointestinal disorders: Dysphagia, fecaloma, fecal [reference.medscape.com]

  […] block / Early / Incidence not known QT prolongation / Rapid / Incidence not known hypoglycemia / Early / Incidence not known glycosuria / Early / Incidence not known gastritis / Delayed / Incidence not known pneumonitis / Delayed / Incidence not known fecal [pdr.net]

• Failure to Thrive

  There are reports of sedation, failure to thrive, jitteriness, and extrapyramidal symptoms (tremors and abnormal muscle movements) in breast-fed infants exposed to risperidone. [pdr.net]

• Jaundice

  […] reaction, angioedema, atrial fibrillation, cardiopulmonary arrest, diabetic ketoacidosis in patients with impaired glucose metabolism, dysgeusia, hypoglycemia, hypothermia, ileus, inappropriate antidiuretic hormone secretion, intestinal obstruction, jaundice [reference.medscape.com]

  If you have ever had yellowing of your skin or the whites of your eyes (jaundice) or a blood disorder. If you have porphyria, a rare inherited blood disorder. If you have a tumour on your adrenal gland, a condition called phaeochromocytoma. [patient.info]

  Yellowing of the skin and whites of the eyes ( jaundice ). Inflammation of the pancreas (pancreatitis). Prolonged erection (priapism). [netdoctor.co.uk]

• Hypotension

  Consider dose reduction if hypotension occurs. [pdr.net]

  Similarly, it’s reasonable to expect that the alpha-blocking properties of bretylium might be additive to those of risperidone, resulting in problematic hypotension. [glowm.com]

  Risperidone should be used with caution in patients with seizure disorders and avoided in states of dehydration and hypotension. [cmaj.ca]

  Special Populations under Dosage and Administration and see Orthostatic Hypotension under Cautions.) [web.archive.org]

• Orthostatic Hypotension

  Monitoring of orthostatic vital signs should be considered in elderly patients for whom orthostatic hypotension is a concern. [pdr.net]

  Dosage and Administration and see Orthostatic Hypotension under Cautions.) [drugs.com]

  CV: tachycardia, chest pain, orthostatic hypotension, prolonged QT interval. EENT: rhinitis, sinusitis, pharyngitis, abnormal vision. GI: constipation, nausea, vomiting, dyspepsia, abdominal pain, anorexia. Metabolic: weight gain. [glowm.com]

  Risperidone may cause a condition called orthostatic hypotension during the early phase of treatment (the first week or two). [medicinenet.com]

• Hypertension

  […] agonists. alpha-adrenergic antagonist An agent that binds to but does not activate alpha -adrenergic receptors thereby blocking the actions of endogenous or exogenous alpha -adrenergic agonists. alpha -Adrenergic antagonists are used in the treatment of hypertension [ebi.ac.uk]

  She had no history of hypertension and was taking no other medicines. Risperidone was discontinued four days later and the nose bleeds stopped. [bmj.com]

  Hypertension 8 : 801–809 Colli A, Cocciolo M, Francobandiera F, Rogantin F, Cattalini N. (1999): Diabetic ketoacidosis associated with clozapine treatment. [dx.doi.org]

  Cardiovascular Research Product Guide A collection of over 250 products for cardiovascular research, the guide includes research tools for the study of: Hypertension Thrombosis and Hemostasis Atherosclerosis Myocardial Infarction Ischemia/Reperfusion [tocris.com]

• Pruritus

  […] reaction (1-5%) Facial edema ( QT prolongation ( Dizziness (1-5%) Extrapyramidal symptoms (EPS; 1-5%) Gynecomastia in children (1-5%) Rash (1-5%) Tachycardia (1-5%) Syncope (1-2%) Bradycardia ( Palpitation ( Chest pain ( Agitation ( Postural dizziness ( Pruritus [reference.medscape.com]

  Hematologic: leukopenia, neutropenia, agranulocytosis Metabolic: dyslipidemia, hyperprolactinemia, hyperglycemia, worsening of diabetes mellitus Musculoskeletal: joint or back pain Respiratory: cough, dyspnea, upper respiratory tract infection Skin: pruritus [medical-dictionary.thefreedictionary.com]

  […] somnambulism / Early / Incidence not known paresthesias / Delayed / Incidence not known hypothermia / Delayed / Incidence not known malaise / Early / Incidence not known chills / Rapid / Incidence not known maculopapular rash / Early / Incidence not known pruritus [pdr.net]

• Alopecia

  […] disorder, listlessness Renal and urinary disorders: Enuresis, dysuria, pollakiuria, urinary incontinence Reproductive system and breast disorders: Vaginal discharge, menstrual disorder, retrograde ejaculation, sexual dysfunction Postmarketing Reports Falls Alopecia [reference.medscape.com]

  DVP (monotherapy vs. combination) Li: 0.6-1.0 mmol/LDVP: 50-100 µg/L 38 8 weeks Patients who became symptomatic with monotherapy had a 89.5% remission rate with combination therapy Five patients discontinued study participation due to adverse events (alopecia [doi.org]

  […] not known skin hyperpigmentation / Delayed / Incidence not known seborrhea / Delayed / Incidence not known night sweats / Early / Incidence not known skin discoloration / Delayed / Incidence not known photosensitivity / Delayed / Incidence not known alopecia [pdr.net]

• Dermatitis

  Incidence not known peripheral edema / Delayed / Incidence not known leukopenia / Delayed / Incidence not known thrombocytopenia / Delayed / Incidence not known neutropenia / Delayed / Incidence not known erythema / Early / Incidence not known atopic dermatitis [pdr.net]

• Acne Vulgaris

  vulgaris / Delayed / 2.0-2.0 syncope / Early / 1.0-2.0 sinusitis / Delayed / 1.0-2.0 injection site reaction / Rapid / 5.0 agitation / Early / Incidence not known restlessness / Early / Incidence not known vertigo / Early / Incidence not known somnambulism [pdr.net]

• Visual Impairment

  Refer to the Instructions for Use section of the product labeling for detailed visual aids which accompany the written instructions. [pdr.net]

• Muscle Spasm

  Tell your doctor right away if you have any serious side effects, including: difficulty swallowing, muscle spasms, shaking (tremor), mental/mood changes (such as anxiety, restlessness), interrupted breathing during sleep. [webmd.com]

  spasms (0-2.6%) Dry mouth (1.7-2.6%) Frequency Not Defined Diabetes mellitus Hyperthermia Hypoglycemia Hypothermia Myelosuppression Neuroleptic malignant syndrome (NMS) Priapism Prolonged QT interval Tardive dyskinesia Thrombotic thrombocytopenic purpura [reference.medscape.com]

  Infants born to women who are treated with RISPERDAL CONSTA® may experience symptoms such as tremors, irritability, excessive sleepiness, eye twitching, muscle spasms, decreased appetite, difficulty breathing, or abnormal movement of arms and legs. [janssenprescriptionassistance.com]

• Motor Restlessness

  These include dyskinesias such as repetitive, involuntary, and purposeless body or facial movements, Parkinsonism (cogwheel muscle rigidity, pill-rolling tremor and reduced or slowed movements), akathisia (motor restlessness, especially in the legs, and [library.neura.edu.au]

  These disorders include akathisia (motor restlessness), dystonia (abnormal muscle tone), and tardive dyskinesia (involuntary and repetitive movements). [ncbi.nlm.nih.gov]

  This may include withdrawal symptoms or extrapyramidal symptoms such as muscle contractions, motor restlessness, rigidity, slowness of movement, tremor and irregular jerky movements. [tabletwise.com]

  At each visit, the primary clinician inquired about health problems, intercurrent illness, and concomitant medications and administered a 32-item questionnaire concerning energy level, muscle stiffness, motor restlessness, bowel and bladder habits, sleep [nejm.org]

• Muscle Cramp

  Call your child’s doctor right away if your child has any fever, muscle cramps or stiffness, dizziness, very bad headache, confusion, change in thinking, fast heartbeat, heartbeat that does not feel normal, or is sweating a lot. [mskcc.org]

  cramps pale, clammy skin poor coordination prolonged, painful, inappropriate erection of the penis puffing of the cheeks rapid or worm-like movements of the tongue shivering talking, feeling, and acting with excitement and activity that cannot be controlled [mayoclinic.org]

  Dantrolene: (Moderate) Simultaneous use of skeletal muscle relaxants and other CNS depressants, such as antipsychotics, can increase CNS depression. [pdr.net]

• Behavior Disorder

  Abstract Risperidone, an atypical antipsychotic drug, is one of the most frequently used atypical neuroleptic drugs for the treatment of symptoms of behavioral disorders seen in autism. [ncbi.nlm.nih.gov]

  Behavior disorders in dementia. In: The Merck manual of geriatrics. Whitehouse Station (NJ): Merck & Co. Inc.; 2000. p. 371-7. 3. ↵ Ballard C, O'Brien J. Treating behavioural disease and psychological signs in Alzheimer's disease. [cmaj.ca]

  Risk of hyperprolactinemia and sexual side effects in males 10–20 years old diagnosed with autism spectrum disorders or disruptive behavior disorder and treated with risperidone. [healio.com]

• Vaginal Discharge

  Psychiatric disorders: Agitation, blunted affect, confusional state, middle insomnia, nervousness, sleep disorder, listlessness Renal and urinary disorders: Enuresis, dysuria, pollakiuria, urinary incontinence Reproductive system and breast disorders: Vaginal [reference.medscape.com]

  discharge / Delayed / Incidence not known libido decrease / Delayed / Incidence not known breast enlargement / Delayed / Incidence not known gynecomastia / Delayed / Incidence not known breast discharge / Delayed / Incidence not known increased urinary [pdr.net]

• Agitation

  Risperidone is a widely accessible antipsychotic that can be used to manage psychosis-induced aggression or agitation. OBJECTIVES: To examine whether oral risperidone alone is an effective treatment for psychosis-induced aggression or agitation. [ncbi.nlm.nih.gov]

  Risperidone is a widely accessible antipsychotic that can be used to manage psychosis-induced aggression or agitation. Objectives: To examine whether oral risperidone alone is an effective treatment for psychosis-induced aggression or agitation. [cochrane.org]

  These trials have important limitations: patients typically had received antipsychotic drugs for years, even though the presence of psychosis or agitation at the initiation of therapy had not been clearly established; the response of psychosis and agitation [nejm.org]

• Seizure

  After the dosage was titrated to 6 mg/d, she experienced generalized seizure attacks. [ncbi.nlm.nih.gov]

  Stop taking and see physician NOW: Seizures. Related Reading What is Risperidone? Tardive dyskinesia Heterocyclic antidepressants Click below to find more related articles on Risperidone. [psyweb.com]

  If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. [medlineplus.gov]

• Akathisia

  Patients with comorbid tic disorders had the poorest rate of response and highest rate of akathisia. [ncbi.nlm.nih.gov]

  The most common adverse reactions that were associated with discontinuation from clinical trials (causing discontinuation in >1% of adults and/or >2% of pediatrics) were nausea, somnolence, sedation, vomiting, dizziness, and akathisia” (see package insert [aap.org]

  >10% Somnolence (40-45%) Insomnia (26-30%) Agitation (20-25%) Anxiety (10-15%) Headache (10-15%) Rhinitis (10-15%) Fatigue (18-31%) Parkinsonism (28-62%) Akathisia (5-11%) Increased appetite (4-44%) Vomiting (10-20%) Drooling ( Urinary incontinence (5 [reference.medscape.com]

• Insomnia

  Outcomes included the positive and negative syndrome scale (PANSS) scores, the curative rate of senile dementia, and prevalence of adverse effects (somnolence, headache, loss of weight, extrapyramidal system response, irritation and insomnia). [ncbi.nlm.nih.gov]

  The evidence did not support the use of atypical antipsychotics in the treatment of substance abuse, and data were inconclusive for the use of these medications for insomnia. [doi.org]

  >10% Somnolence (40-45%) Insomnia (26-30%) Agitation (20-25%) Anxiety (10-15%) Headache (10-15%) Rhinitis (10-15%) Fatigue (18-31%) Parkinsonism (28-62%) Akathisia (5-11%) Increased appetite (4-44%) Vomiting (10-20%) Drooling ( Urinary incontinence (5 [reference.medscape.com]

• Reduced Consciousness

  […] dark urine with muscle tenderness or aching an erection that lasts more than 4 hours without sexual stimulation fast or irregular heartbeat high fever increased sweating large changes in body temperature loss of bladder control reduced consciousness [chealth.canoe.com]

• Hyperprolactinemia

  Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia. [ncbi.nlm.nih.gov]

  Although risperidone ranks high among atypical neuroleptics in producing hyperprolactinemia, unlike what many legal advertisements claim or suggest, no direct connection has been established between hyperprolactinemia and gynecomastia. [healio.com]

• Prolonged QT Interval

  BACKGROUND: Numerous structurally unrelated drugs, including antipsychotics, can prolong QT interval and trigger the acquired long QT syndrome (aLQTS). All of them are thought to act at the level of KCNH2, a subunit of the potassium channel. [ncbi.nlm.nih.gov]

  Bradycardia, electrolyte imbalance, use with other drugs that prolong the QT interval, or congenital prolongation of the QT interval can increase risk for occurrence of this arrhythmia. • Drug has an antiemetic effect in animals; this may occur in humans [glowm.com]

  People taking other medicines that can increase the risk of a 'prolonged QT interval' (see end of factsheet for examples). [netdoctor.co.uk]

  QT interval Tardive dyskinesia Thrombotic thrombocytopenic purpura (TTP) Sleep apnea syndrome Urinary retention Blood and lymphatic system disorders: Anemia, granulocytopenia Cardiac disorders: Tachycardia, sinus bradycardia, sinus tachycardia, atrioventricular [reference.medscape.com]

RESULTS: PANSS scores before treatment were comparable between treatment groups. On days 7, 15, 30, and 60 of the treatment, the differences between two treatment groups became evident. [ncbi.nlm.nih.gov]

Dual diagnosis can have an adverse effect on treatment and prognosis of SMI. [ncbi.nlm.nih.gov]

Tomotaka Suzuki, Masayuki Takase, Toshihiro Moriyama, Hiroyuki Watanabe, Toyoaki Hirata, Makoto Asano and Masaomi Iyo, Impact of dopamine supersensitivity psychosis in treatment-resistant schizophrenia: An analysis of multi-factors predicting long-term prognosis [doi.org]

The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. [ncbi.nlm.nih.gov]

There were no significant differences in respect to age, gender, stage of disease, etiologies of delirium and sum of etiologies. [scielo.isciii.es]

Gynecomastia in German soldiers: etiology and pathology. GMS Interdiscip Plast Reconstr Surg. DGPW; 2012; 1: Doc 03. doi:10.3205/iprs000003 [CrossRef]. Shores LE. [healio.com]

Cambridge, Cambridge University Press Stein L, Wise CD. (1971): Possible etiology of schizophrenia: progressive damage to the noradrenergic reward system by 6-hydroxydopamine. [dx.doi.org]

Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data. Am J Epidemiol 2001 ; 154 : 854 -64. 20. ↵ Romano PS, Roos LL, Jollis JG. [dx.doi.org]

Principle mechanisms underlying venous thromboembolism: Epidemiology, risk factors, pathophysiology and pathogenesis. Respiration 2003;70:7-30. [ PUBMED ] 3. Anderson FA Jr., Spencer FA. Risk factors for venous thromboembolism. [jmhhb.org]

Barbui, New EMA report on paliperidone 3-month injections: taking clinical and policy decisions without an adequate evidence base, Epidemiology and Psychiatric Sciences, 10.1017/S2045796016001025, 26, 3, (231-233), (2016). [doi.org]

Diagnosis, Epidemiology and Management of Mixed States in Bipolar Disorder. CNS Drugs, Vol. 29, Issue. 9, p. 725. CrossRef Google Scholar Berger, Michael Lewitzka, Ute and Seemüller, Florian 2015. Akutbehandlung manischer Episoden. [cambridge.org]

Epidemiology of Delirium. Dement Geriatr Cogn Disord 1999; 10(5): 315-318. [ Links ] 3. Lipowski ZJ. Delirium in the elderly patient. N Engl J Med 1989; 320(9): 578-582. [ Links ] 4. Bond SM, Neelon VJ, Belyea MJ. [scielo.isciii.es]

Pathophysiological mechanisms implicated in the development of AEP in our patient seem to be associated with eotaxin and serotonin eosinophilic-specific chemoattracting action, through the serotoninergic action of risperidone. [ncbi.nlm.nih.gov]

Precise pathophysiologic understanding of the hematologic side effects of antipsychotics is lacking, although different mechanisms of action have been proposed. 3 Possible mechanisms when a patient is taking clozapine or olanzapine include: • direct toxic [mdedge.com]

Principle mechanisms underlying venous thromboembolism: Epidemiology, risk factors, pathophysiology and pathogenesis. Respiration 2003;70:7-30. [ PUBMED ] 3. Anderson FA Jr., Spencer FA. Risk factors for venous thromboembolism. [jmhhb.org]

Routine physical and laboratory examinations may prevent silent disease progression. [ncbi.nlm.nih.gov]

This announcement marks another step forward in our strategic, comprehensive, and effective approach to fraud prevention. We can all be encouraged by the actions that have been taken – and the results we’ve obtained – in recent years. [justice.gov]

Lamotrigine, olanzapine, and quetiapine have bimodal efficacy in preventing both mania and depression, although lamotrigine’s efficacy is more robust in preventing depression and olanzapine’s efficacy is greater in preventing mania. [doi.org]