This potent medication should not be used in elderly patients with signs of dementia as Risperdal has been shown to increase mortality rates in this population.
The FDA approval for use in children as young as 5 years of age was preceded by very short-term (4 week to 12 week) trials. Again, caution is always prudent as stated in FDA Risperdal labeling information. (1)
There are a host of known side-effects and warnings concerning Risperdal (risperidone) issued by the FDA that apply to every age group and these topics and other frequently requested information are further described below.
There are three FDA approved uses for Risperdal, and other uses that have become common in the off-label context.
Over time, off label uses have come to include:
Please be advised that no bonafide studies have been completed that show any efficacy using Risperdal for such disorders.
Quite to the contrary, in 2012 and again in 2013 the makers of Risperdal, Johnson & Johnson and a subsidiary, Janssen Pharmaceuticals, were sued across 36 states for misleading claims promoting that the drug was effective for the treatment of anger-management, and anxiety.
Other cases brought against the drug makers were settled after the company promoted Risperdal as effective in the treatment of dementia, a practice that is now banned by the FDA due to the patient’s risk of death.
Lawsuit claims resulted in fines of over $2.5 billion that J&J were forced to pay for their over-reaching claims attributed to Risperdal.
More can be learned about certain “sales over science” marketing techniques by researching published research articles on this topic. (7)
Risperdal has not developed a reputation as a street drug, though because of its psychoactive effects, this can not be ruled out completely. No street names are known at this time.
There are several brand names for the generic drug, including:
Long term use of Risperdal has not been studied, i.e. for longer than 4-8 weeks, which was the length of the pre-marketing trials for the drug.
Some of the most common side effects of Risperdal include:
Some less common but more severe effects include:
This is not an all-inclusive list. If you notice discomforts see your doctor without delay, so that medical attention can be given in time to avert any potential health crisis.
Risperdal (risperidone) is recommended to be tapered down gradually over sudden cessation, unless the latter is needed to avert death due to allergic or other severe reaction.
The most commonly reported withdrawal symptoms include:
Other withdrawal symptoms included these more severe ones:
Coming off an atypical antipsychotic drug can be difficult. Seek medical guidance and consult with your prescribing physician to help navigate through the process.
If your prescribing physician is unwilling to help or simply unable guide you because of unfamiliarity with the problem, it is always a good idea to seek a second opinion. It is not at all unusual to meet with such resistance, because physicians are typically not trained during their schooling in drug tapering. Realize the problem needs expertise for your best way forward.
As with all other psychoactive medications, the gradual cessation of this medication is the safer approach. There are a few exceptions to this general standard rule, however.
When a patient develops a life-threatening adverse reaction such as tardive dyskenisia, NMS, Stevens – Johnson syndrome, organ failure, interactions with other drugs or substances, or other high risk events, the drug must be withdrawn immediately in a clinical setting, to save the life of the patient.
It is believed that Risperdal has the ability to block dopamine at the D2 dopamine receptor and by reducing dopamine availability, reduce manic symptoms. Most psychiatric medications are limited due to the neuroadaptation of the synapse. The synapse, in response to a perceived dopamine deficiency, can then increase the receptors binding power to dopamine. (9)
This increased D2 dopamine binding and upregulation is a potential mechanism for the development of tardive dyskenisia. This receptor upregulation is most likely a central component in the manifestations of antipsychotic medication withdrawal. For some, antipsychotic withdrawal can be extremely challenging, more so than any of the drug classes including benzodiazepines and even opiates such as heroin.
As the antipsychotic medication is lowered, dopamine flow will begin to return. This previously restricted dopamine coming into contact with upregulated receptors may clinically present as an abrupt onset of manic or psychotic symptomatology. It is common for the patient to become enamored with what they are feeling. The sense of reward they may experience could be likened to winning the lottery, In other words, it can be extreme. This newfound reward could leave them resistant to either increasing the medication to assist in regaining stability, or slowing down the medication taper. This aversion to proper guidance can make this situation very hard to manage.
It is advised that when attempting an antipsychotic medication withdrawal, that it is made clear early in the process, that this is a possibility; and, furthermore, that the individual be encouraged to make a pact that they will listen to at least one person without question. If they sign something saying that they will take this trusted person’s direction in the event that their own judgment cannot be trusted, it can be something that can be presented to them if things start to run awry. Obviously this will not work for everyone in this situation, but for some, especially those with a strong family alliance, this can be a successful agreement.
Another form of preemptive strategy is to enlist a doctor or center that has hospital admission privileges. Should things get to the point where restabilization is necessary, a doctor that has the ability to admit the patient to the hospital can help things go in a humanistic way so that future reduction efforts may be entertained.
It should also be noted that there should be a strictly adhered to restriction of stimulants such as coffee and other forms of caffeine, etc., during this time. Even medications like Wellbutrin, Effexor, and SNRI’s may pose challenges during an antipsychotic medication withdrawal, and having a conversation with your doctor about this potential would be advisable.
Below is a collection of information about Risperdal and how it works, what it is and is not FDA approved for, and many other topics of interest on this atypical antipsychotic medication.
It is high recommended to thoroughly research a drug before starting or stopping it so your health questions can be fully addressed, and your ability to reach the best solutions to mental health issues is supported by science rather than perhaps overzealous advertising claims that may conflict with documented evidence.
There are some studies which have found that chelation to remove heavy metals from the body have been beneficial in some cases of childhood autism, though published comprehensive studies on this subject are not easy to access. (5)
However, the chelation (removal) of toxic levels of heavy metals has been documented as helpful for many conditions in the adult population. (6)
At the Alternative to Meds Center, we offer a program designed individually to help a person taper off medications safely, with a minimum amount of discomfort, and maximum health improvements.
A thorough program has been designed to address numerous health issues that may have been overlooked, and certainly not investigated much if at all before a prescription of medication such as Risperdal. One highly effective protocol used in the program is heavy metal toxicity, which is tested for and analyzed. The offending contaminants once found are then systematically and gently removed as part of a comprehensive series of steps that aim to provide a pathway to natural mental health. Some of these steps include nebulized glutathione treatments, low-temperature sauna, bentonite clay treatments, food-grade supplements, clean diet, mild exercise, and various other adjunct therapies to improve overall health and well-being before, during and post-taper.
These are important and useful treatments for anyone who wishes to not only taper from medications safely, but to address the symptoms that led to the prescription in the first place.
Please contact us for more information on these and other treatments available at our comfortable, inpatient, retreat-styled treatment center.
Dr Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona. He holds a Bachelor’s of Science degree with a major in biology and minors in chemistry and philosophy. He graduated Creighton University School of Medicine with a Doctor of Medicine. Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.