Dosage
For schizophrenia: Start with 2-4 mg divided into 1-2 doses per day. The maximum dose here is 8 mg. In mania: A dose of 3-4 mg a day is recommended.
The dose of 6 mg should not be exceeded. In case of dementia: In this case the medication should be taken very carefully. It is recommended to take an initial dose of 2×0.25 mg.
In the absence of side effects the target dose should be 2×0.5 mg. In individual cases one can continue to increase the dosage in 1/4 mg steps. With the depot medication one starts nowadays with 25 mg every 2 weeks.
Depending on the severity of the disorder, however, doses of 37.5 mg and 50 mg (maximum dose) are also possible. Borderline disorder: Both self-injury and “psychosis-related” conditions are unfortunately not uncommon in borderline disorders. In my experience, dosages of between 1-3 mg Risperdal® are helpful in this case in order to get a good grip on both the pressure of self-injury and any “psychosis-like” misperceptions.
Of course, a purely drug-based therapy can never replace borderline-oriented psychotherapy. In individual cases, the dosage may be higher (depending on the severity of the injury or the probability of relapse). While switching from tablets to depot medication, simultaneous treatment must be carried out for about 3 weeks, as the depot has no immediate effect.
Side effects
The most common (in up to 20% of patients) with Risperdal® are the so-called EPS (extrapyramidal disorders). These include side effects related to motor skills and movement in the broadest sense. EPS is basically divided into: Early dyskinesias: These include symptoms such as physical restlessness, muscle twitching, unintentional tongue sticking out, eye cramps.
These disorders recede after the medication is discontinued. Late dyskinesias: These symptoms can occur after years of taking neuroleptics. The symptoms are similar to those of early dyskinesias.
In addition, there are typical movement patterns and facial movements. These disorders are permanent.Author’s note: In my medical career to date, I have never encountered late dyskinesia caused by Risperdal®. Parkinsonoid: These symptoms are reminiscent of the clinical picture of Parkinson’s disease.
It results in a limitation or loss of fine motor skills, small-step walking, tremor, general stiffness (rigor) and loss of facial muscle movement (amimia). Acaesia: This is a very agonizing sitting restlessness. Patients cannot remain seated calmly despite their best efforts, but typically “bounce” up and down. Other common side effects are: Insomnia, headaches, drop in blood pressure and dizziness are rarer side effects: Potency disorders (erectile dysfunction), nausea, milk flow In individual cases, (epileptic) seizures and a drop in white blood cells (leukopenia) may occur.
