Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Second-Generation Antipsychotic

Risperidone

Brand names: Risperdal

Risperidone is a second-generation (atypical) antipsychotic used in schizophrenia, bipolar mania, and short-term for persistent aggression in dementia or autism when other measures have failed.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Table 1. Recommended Daily Dosage by Indication Initial Dose Titration (Increments) Target Dose Effective Dose Range Schizophrenia: adults ( 2.1 ) 2 mg 1 to 2 mg 4 to 8 mg 4 to 16 mg Schizophrenia: adolescents ( 2.2 ) 0.5 mg 0.5 to 1 mg 3 mg 1 to 6 mg Bipolar mania: adults ( 2.2 ) 2 to 3 mg 1 mg 1 to 6 mg 1 to 6 mg Bipolar mania: children and adolescents ( 2.2 ) 0.5 mg 0.5 to 1 mg 1 to 2.5 mg 1 to 6 mg Irritability in autistic disorder ( 2.3 ) 0.25 mg Can increase to 0.5 mg by Day 4: (body weight less than 20 kg) 0.5 mg Can increase to 1 mg by Day 4: (body weight greater than or equal to 20 kg) After Day 4, at intervals of > 2 weeks: 0.25 mg (body weight less than 20 kg) 0.5 mg (body weight …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-05-21. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It antagonises dopamine D2 and serotonin 5-HT2 receptors.

Prescribing in practice

  • It raises prolactin more than some other atypicals (galactorrhoea, sexual and menstrual effects) and causes dose-related extrapyramidal effects.
  • In dementia it is one of the few licensed short-term options for persistent aggression, but antipsychotics increase stroke and mortality risk — use the lowest dose for the shortest time.
  • Metabolic effects, sedation, postural hypotension and QT prolongation can occur.

Monitoring

Monitor weight, glucose and lipids, blood pressure, prolactin-related symptoms and movement disorders; review the need to continue.

Counselling the patient

  • Rise slowly to avoid dizziness.
  • Report breast symptoms, abnormal movements or marked stiffness.
  • Do not stop it suddenly.

Evidence & guidelines

Used in schizophrenia and bipolar mania and, short-term, for persistent aggression in dementia (licensed and time-limited), with the antipsychotic stroke and mortality warning.

Reference: MHRA Drug Safety Update 2004 (risperidone BPSD); NICE NG97 (Dementia); AGS Beers Criteria 2023; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways