Risperidone: What It Is, How It Works, and Practical Tips

Risperidone is a prescription antipsychotic used to treat schizophrenia, bipolar disorder, and irritability linked to autism. It changes how certain brain chemicals work, mainly lowering dopamine activity. People take it as tablets, an oral solution, or a long-acting injection your doctor gives every two weeks.

Why would someone get risperidone? It helps reduce hallucinations, extreme mood swings, and aggressive behavior. Doctors often start with a low dose and raise it slowly until symptoms improve. Many adults find relief on doses commonly between 2 and 6 mg per day, but your doctor will tailor the dose to you.

Common side effects and what to watch for

Side effects you might notice include drowsiness, weight gain, feeling shaky or stiff (extrapyramidal symptoms), and changes in sexual function due to raised prolactin. Some people develop higher blood sugar or cholesterol, so try to check weight, fasting glucose, and lipids regularly. If you feel unusually stiff, have tremors, high fever, or confusion, contact your provider — these can be signs of a rare but serious reaction.

Older adults with dementia-related psychosis have a higher risk of death on antipsychotics; risperidone is not approved for that use. Pregnant or breastfeeding people should discuss risks and benefits with their clinician before starting risperidone.

Practical tips for taking risperidone

Take risperidone exactly as the prescriber tells you. You can take it with or without food. Because it can make you sleepy or dizzy, avoid driving or heavy machinery until you know how it affects you. Skip alcohol — it increases sleepiness and can worsen side effects.

If you miss a dose, take it as soon as you remember unless the next dose is near; never double up. Don’t stop suddenly without medical advice — stopping quickly can cause withdrawal or symptom relapse. For long-acting injections, keep scheduled appointments; missed injections should be rescheduled and you may need oral medication until the injection works again.

Be upfront about other medicines you take. Some antidepressants and heart medicines can change risperidone levels. Drugs that speed up liver enzymes may lower its effect, while certain inhibitors can raise levels. Tell your prescriber about any history of diabetes, heart problems, or movement disorders.

Monitoring helps you stay safe: expect periodic checks of weight, blood pressure, blood sugar, lipids, movement symptoms, and sometimes prolactin. If side effects become a problem, your clinician may change the dose, switch drugs, or add treatments to reduce symptoms.

Questions for your prescriber: How long before I see improvement? What dose is best for me? What side effects should prompt a call? Keep a simple symptoms diary to track benefits and issues — it makes clinic visits more useful.

Long-acting risperidone (Risperdal Consta) can help when pills are hard to manage. A related drug, paliperidone, works similarly and is sometimes used as an alternative. If you shop online for medication, only use licensed pharmacies and keep your prescription. If cost is an issue, ask your clinic about patient assistance or generic options—talking about money is okay and can save you headaches.