Orotral (Risperidone)

Risperidone is an atypical antipsychotic that acts on dopamine and serotonin pathways to treat several psychiatric conditions.

• Schizophrenia: Reduces hallucinations, delusions and thought disorder.
• Bipolar I disorder (manic episodes): Stabilises mood and decreases manic symptoms.
• Irritable‑behaviour associated with autistic spectrum disorder: Improves irritability and aggression.
• Tourette syndrome: Decreases frequency and severity of motor and vocal tics.

• Risperidone exerts its antipsychotic effect by antagonising dopamine D2 receptors and serotonin 5‑HT2A receptors, with additional activity at α‑adrenergic and histamine H1 receptors. This receptor profile modulates neurotransmission in the mesolimbic and mesocortical pathways, helping to balance dopaminergic and serotonergic activity that underlies psychotic and mood symptoms.

Side effects vary in frequency and severity and are monitored during treatment.

Common Side Effects

• Sedation or drowsiness
• Weight gain
• Increased prolactin levels
• Dry mouth
• Constipation
• Dizziness

Serious or Rare Side Effects

• Extrapyramidal symptoms (e.g., dystonia, akathisia)
• Neuroleptic malignant syndrome
• Tardive dyskinesia
• Severe orthostatic hypotension
• Hyperglycaemia or new‑onset diabetes
• Seizures

Patients should be evaluated for medical history and monitored regularly while using risperidone.

• Cardiovascular assessment: Check for arrhythmias or prolonged QT interval.
• Metabolic monitoring: Track weight, fasting glucose and lipid profile.
• Endocrine evaluation: Monitor for signs of hyperprolactinemia.
• Neurological review: Observe for extrapyramidal signs or movement disorders.
• Pregnancy and lactation: Use only if benefits outweigh risks.
• Store at ambient temperature: keep in the original container, protect from moisture and light.

Risperidone may interact with several drug classes; clinicians should review patient medication lists. Major Interactions (Avoid):\n- Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole).

• Concomitant use with other antipsychotics combined .
• CNS depressants .

Moderate Interactions (Monitor Closely)

• CYP2D6 poor‑risk .
• Antihypertensive agents.
• Anticholinergic drugs.
• Medications that prolong .
• Alcohol .
• Tobacco .
• Antifungal .

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