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" What is it used for?  Psychotic illness such as schizophrenia in adults over 18 years of age. Manic episodes of manic depression (bipolar affective disorder) in adults over 18 years of age.  Short-term treatment (up to six weeks) of persistent aggression in people with moderate to severe Alzheimer&amp;#039;s dementia. This medicine should only be used for people with Alzheimer&amp;#039;s whose aggressive behaviour is unresponsive to non-drug approaches and when there is a risk of the person harming themself or others. Short-term treatment (up to six weeks) of persistent aggression in children aged five years and over and adolescents who have conduct disorder and are intellectually disabled. This medicine may be used when the severity of aggressive or other disruptive behaviours are thought to require drug treatment. It should only be used as part of a more comprehensive treatment programme that includes psychosocial and educational intervention.   How does it work? Risperdal tablets, liquid and quicklets all contain the active ingredient risperidone, which is a type of medicine known as an atypical antipsychotic. Risperidone is also available without a brand name, ie as the generic medicine. Risperidone works in the brain, where it affects various neurotransmitters, in particular dopamine and serotonin (5HT). Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells.  Dopamine and serotonin are neurotransmitters known to be involved in regulating mood and behaviour, amongst other things. Psychotic illness is considered to be caused by disturbances in the activity of neurotransmitters (mainly dopamine) in the brain. Schizophrenia is known to be associated with an overactivity of dopamine in the brain, and this may be associated with the delusions and hallucinations that are a feature of this disease.  Risperidone works by blocking the receptors in the brain that dopamine acts on. This prevents the excessive activity of dopamine and helps to control schizophrenia.  Schizophrenic patients may experience &amp;#039;positive symptoms&amp;#039; (such as hallucinations, disturbances of thought, hostility) and/or &amp;#039;negative symptoms&amp;#039; (such as lack of emotion and social withdrawal). Risperidone is effective in relieving both positive and negative symptoms of schizophrenia, whereas the conventional antipsychotics are usually less effective against the negative symptoms.   Risperidone also relieves &amp;#039;affective symptoms&amp;#039; that are associated with schizophrenia, such as depression, guilt feelings or anxiety. Risperidone is used by specialists to treat episodes of mania in people with the psychiatric illness, bipolar affective disorder (manic depression). Risperidone may also be used by specialists to treat severe aggressive behaviour in elderly people with Alzheimer&amp;#039;s disease, and in intellectually disabled children with conduct disorder.  Risperidone can be taken as liquid, conventional tablets or Risperdal quicklets. Risperdal quicklets are tablets that are designed to dissolve on the tongue and be swallowed with the saliva, without the need for water. For the treatment of schizophrenia, risperidone can also be given as a depot injection that lasts for two weeks. See the link to Risperdal consta at the end of this factsheet for more information.    How do I take it?  The dose of this medicine that is prescribed and how often to take that dose will vary from person to person depending on the condition being treated. It is important to follow the instructions given by your doctor. These will also be printed on the dispensing label that your pharmacist has put on the packet of medicine. If you are unclear about anything you should ask your doctor or pharmacist for advice. Risperidone can be taken either with or without food. Risperdal tablets should be swallowed with a drink of water. Risperdal quicklets should be placed on your tongue, where they rapidly dissolve in your saliva for easy swallowing. You can take them with a little water if you want to. The quicklets are fragile and should not be pushed through the foil as this will damage them. With dry hands, open the blister by pulling up the edge of the foil and peeling it off, then tip the tablet out. The quicklet should be taken as soon as you have opened the blister. It cannot be stored once removed.  Follow the instructions that are supplied with Risperdal liquid for measuring a dose carefully. Risperdal liquid can be taken as it is, or it may be diluted with any non-alcoholic drink except tea. When diluted in this way, the mixture should be taken immediately and not saved for later. If you forget to take a dose you should not take a double dose to make up for it. Just take your next dose as usual.  Unless your doctor tells you otherwise, you should not suddenly stop taking this medicine, even if you feel better and think you don&amp;#039;t need it any more. This is because the medicine controls the symptoms of the illness but doesn&amp;#039;t actually cure it. This means that if you suddenly stop treatment your symptoms could come back. Stopping the medicine suddenly may also rarely cause withdrawal symptoms such as sweating, nausea, vomiting, difficulty sleeping or tremor. When treatment with this medicine is stopped, it should be done gradually, following the instructions given by your doctor.    Warning!  This medicine may cause drowsiness or dizziness. If affected do not drive or operate machinery. You should avoid drinking alcohol while taking this medicine because it is likely to make any drowsiness worse. This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing, especially when you first start taking the medicine. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass. This medicine can cause some people to put on weight. Talk to your doctor about this before you start treatment so that you can discuss strategies, such as diet and exercise, for minimising any weight gain. Antipsychotic medicines can sometimes affect the ability of the body to control its core body temperature. This is more likely to be a problem in elderly people and can result in heat stroke in hot temperatures and hypothermia in cold temperatures. It is important to avoid situations that can result in you overheating or getting dehydrated. Ask your doctor or pharmacist for more advice. Antipsychotic medicines are associated with an increased risk of getting a blood clot in a vein (deep vein thrombosis) or in the lungs (pulmonary embolism). For this reason, you should consult a doctor immediately if you get any of the following symptoms, which could suggest you have a blood clot: stabbing pains and/or unusual redness or swelling in one leg, pain on breathing or coughing, coughing up blood or sudden breathlessness.  Consult your doctor immediately if you experience any abnormal movements, particularly of the face, lips, jaw and tongue, while taking this medicine. These symptoms may be indicative of a rare side effect known as tardive dyskinesia, and your doctor may ask you to stop taking this medicine, or decrease your dose. Consult your doctor immediately if you experience the following symptoms while taking this medicine: high fever, sweating, muscle stiffness, faster breathing and drowsiness or sleepiness. These symptoms may be due to a rare side effect known as the neuroleptic malignant syndrome, and your treatment may need to be stopped. There is an increased risk of stroke and death in elderly people with dementia who are treated with antipsychotic medicines such as this one. The risk is higher in people with forms of dementia that are not related to Alzheimer&amp;#039;s disease, and this medicine should not be used in those people. In Alzheimer&amp;#039;s dementia, this medicine should only be used to control aggressive behaviour that poses a risk to the patient themself, or to others. It should only be used when non-drug approaches to control the behaviour have been unsuccessful. The treatment should be limited to six weeks use only and should only be started under specialist advice. During treatment, caregivers should report any possible symptoms of a stroke to the patient&amp;#039;s doctor immediately; these may include sudden weakness or numbness in the face, arms or legs, and problems with speech or vision. When used to treat conduct disorder in intellectually disabled children, this medicine should only be prescribed by a specialist in child neurology or psychiatry. The possible causes of the aggressive behaviour must have been fully investigated before treatment is started. If the child experiences tiredness as a result of taking the medicine this could affect their learning ability, but changing the time of day the medicine is taken can sometimes help with this. Your doctor will want to monitor the child&amp;#039;s growth and development, since this medicine can potentially affect levels of a hormone called prolactin, which is involved in growth and sexual development. It is important to let your doctor know if your child experiences any unwanted effects as a result of taking this medicine.  If you are scheduled to have eye surgery for cataracts it is important to let your eye specialist know if you are or have been taking this medicine. The specialist needs to know if you have been taking this medicine so they can take appropriate precautions with the medicines and techniques they use during the surgery.    Use with caution in  Elderly people. Elderly people with Alzheimer&amp;#039;s dementia who are also being treated with furosemide or other strong diuretics. It is important that dehydration is avoided in these people. Liver disease. Kidney disease. People who are dehydrated. Low blood pressure (hypotension). High blood pressure (hypertension). People with disease involving the heart and blood vessels (cardiovascular disease) for example heart failure, angina, previous heart attack or an irregular heartbeat (arrhythmia). People with a very slow heart rate (bradycardia).  People with a personal or family history of an abnormal heart rhythm seen as a &amp;#039;prolonged QT interval&amp;#039; on a heart monitoring trace or ECG. People taking other medicines that can increase the risk of a &amp;#039;prolonged QT interval&amp;#039; (see end of factsheet for examples). People with disturbances in the levels of salts (electrolytes) in their blood, especially low blood potassium or magnesium levels. People with a history or risk of stroke or small temporary strokes (transient ischaemic attacks).  People with a personal or family history of blood clots (venous thromboembolism), for example in a vein of the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).  People with other risk factors for getting a blood clot, for example smoking, being overweight, taking the contraceptive pill, being over 40, recent major surgery or being immobile for prolonged periods. Diabetes. (If you have diabetes your blood sugar levels should be monitored closely while you are having treatment with this medicine, because it may increase your blood sugar.) 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&amp;#039;s disease. People with high levels of the hormone prolactin in the blood (hyperprolactinaemia). People with a tumour that is possibly dependent on prolactin, eg breast cancer.   Not to be used in  People with dementia that is not caused by Alzheimer&amp;#039;s disease, for example mixed or vascular dementia. Risperdal tablets contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Risperdal quicklets contain aspartame and should not be taken by people with an inherited disorder of protein metabolism called phenylketonuria.  This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  The safety of this medicine during pregnancy has not been established. It should not be used in pregnancy, particularly in the first and third trimesters, unless considered essential by your doctor. If the medicine is used during the third trimester it could cause side effects or withdrawal symptoms in the baby after birth and the baby may need extra monitoring because of this. Seek further medical advice from your doctor.  If you do get pregnant while taking this medicine it is important to consult your doctor straight away for advice. You should not suddenly stop taking this medicine unless your doctor tells you to, as this could cause your symptoms to come back.  This medicine passes into breast milk. The effect of this on a nursing infant are not known. It is recommended that women who need to take this medicine should not breastfeed unless the potential benefits of breastfeeding outweigh any risks to the nursing infant. It is important to seek medical advice on this from your doctor.    Label warnings  This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.    Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.  Very common (affect more than 1 in 10 people)  Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, stiffness, rigidity, slowness or difficulty of movements (Parkinsonism or extrapyramidal effects). Increased salivation. Headache. Difficulty sleeping (insomnia).   Common (affect between 1 in 10 and 1 in 100 people)  Sleepiness, fatigue or sedation. Dizziness. Restlessness, agitation or anxiety. Change in appetite. Weight gain - see warning section above. Increased level of the hormone prolactin in the blood (hyperprolactinaemia) - uncommonly this may lead to symptoms such as breast enlargement, production of breast milk and menstrual disturbances. Blurred vision. Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose. Nosebleeds. Cough or shortness of breath. Dry mouth. Disturbances of the gut such as constipation, diarrhoea, nausea, vomiting, indigestion or abdominal pain. Swollen ankles. Fast heartbeat. Chest pain. Fever.   Uncommon (affect between 1 in 100 and 1 in 1000 people)  Confusion. Sexual problems such as reduced sex drive, erectile dysfunction or inability to orgasm. Low blood pressure, and drops in blood pressure when moving from a lying down or sitting position to standing up that may cause dizziness or fainting. Muscle or joint pain, weakness or stiffness. Skin reactions such as rash, itching, hair loss, acne, discolouration, dry or flaky skin. Ear pain, sensation of ringing or other noise in the ears (tinnitus). Red, watery or dry eyes, conjunctivitis. Problems with speech, attention, balance or co-ordination. Tardive dyskinesia (see warning section above). Stroke or mini-stroke. Change in taste. Irregular heart rhythms. Awareness of your heartbeat (palpitations). Increased blood glucose levels or diabetes. Tell your doctor if you notice you feel unusually hungry or thirsty, or need to pass urine more often than usual. People with diabetes should monitor their blood sugar closely. Raised levels of fats called cholesterol or triglycerides in the blood.  Increased body temperature. Pain or difficulty passing urine. Excessive need to pass urine or urinary incontinence. Infection of the breathing passages, eg sinusitis, flu, bronchitis. Decreased numbers of red blood cells, white blood cells or platelets in the blood. You should consult your doctor if you experience any of the following symptoms: unexplained bruising or bleeding, purple spots, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness. Your doctor may want to take a blood test to check your blood cells.   Rare (affect between 1 in 1000 and 1 in 10,000 people)  Neuroleptic malignant syndrome (see warning section above). Yellowing of the skin and whites of the eyes (jaundice). Inflammation of the pancreas (pancreatitis). Prolonged erection (priapism). If you get an erection that lasts longer than four hours while taking this medicine, you should consult a doctor immediately. Treatment of this condition should not be delayed more than six hours, as this can cause damage to the erectile tissue in the penis and irreversible erectile dysfunction.  Problem with eye movement such as rolling of the eyes.  Blood clot in the leg or the lungs (thromboembolism) \u2013 see warning section above.  The side effects listed above do not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.   How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.  There may be an increased risk of drowsiness and sedation if risperidone is taken with any of the following (which can also cause drowsiness):  alcohol barbiturates, eg amobarbital, phenobarbital benzodiazepines, eg diazepam, temazepam MAOI antidepressants, eg phenelzine sedating antihistamines, eg chlorphenamine, hydroxyzine  sleeping tablets, eg zopiclone  strong opioid painkillers, eg morphine, codeine tricyclic antidepressants, eg amitriptyline.   Risperidone may enhance the blood pressure-lowering effects of medicines that lower blood pressure, including medicines used to treat high blood pressure (antihypertensives) and medicines that lower blood pressure as a side effect, eg benzodiazepines. If you are taking medicines that lower blood pressure you should tell your doctor if you feel dizzy or faint after starting treatment with this medicine, as your doses may need adjusting. There may be an increased risk of abnormal heart rhythms (prolonged QT interval on a heart monitoring trace or ECG) if this medicine is taken in combination with any of the following medicines:   antiarrhythmics (medicines to treat abnormal heart beats), eg amiodarone, procainamide, disopyramide, sotalol  the antihistamines astemizole, mizolastine or terfenadine  arsenic trioxide  atomoxetine  certain antidepressants, eg amitriptyline, imipramine, maprotiline certain antimalarials, eg halofantrine, chloroquine, quinine, mefloquine, Riamet  certain other antipsychotics, eg thioridazine, haloperidol, sertindole, pimozide cisapride dronedarone droperidol   intravenous erythromycin or pentamidine methadone  moxifloxacin saquinavir.   There may also be an increased risk of a prolonged QT interval if medicines that can alter the levels of salts such as potassium or magnesium in the blood, eg diuretics such as furosemide, are taken in combination with risperidone. Risperidone may oppose the effect of medicines for Parkinson&amp;#039;s disease that work by stimulating dopamine receptors in the brain, for example levodopa, ropinirole, pergolide, bromocriptine. Risperidone may oppose the effect of anticonvulsant medicines used to treat epilepsy.  Risperidone may increase blood sugar levels and disturb the control of diabetes. People with diabetes may need an adjustment in the dose of their antidiabetic medication.  Risperidone may oppose the effect of histamine (used to treat leukaemia) and is not recommended for people having this treatment.  The following medicines may speed up the breakdown of risperidone in the body and so could make it less effective. If you take any of these medicines your doctor may need to increase your dose of risperidone:  carbamazepine phenytoin rifampicin.  The following medicines may slow down the breakdown of risperidone in the body and so could increase the amount in the blood. If you take any of these medicines your doctor may need to prescribe a lower dose of risperidone:  fluoxetine paroxetine verapamil.  This medicine should not be used in combination with paliperidone.   Other medicines containing the same active ingredient    Risperdal consta      Risperidone tablets are also available without a brand name, ie as the generic medicine.  Last updated 11.07.2012 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/brain-and-nervous-system/a7483/risperdal-risperidone/>