Headache risperidone

Insomnia, hypotension, agitation, headache, and rhinitis are the most common side effects of risperidone. These tend to lessen with time. Overall, the drug tends to be well tolerated. Average weight gain associated with risperidone after 10 weeks of treatment is 2.10 kg (AUison et al. 1999). Risperidone does not have significant anticholinergic side effects. Hyperprolactinemia is common. 

In an 8-week study, pre-school-age children with bipolar disorder (aged 4-6 years) took either olanzapine (n = 15 mean age 5.0 years 10 boys mean dose 6.3 mg/day) or risperidone (n = 16 mean age 5.3 years 12 boys mean dose 1.4 mg/day) (59). There were significantly more dropouts with olanzapine (6 versus 1), including one patient who withdrew because of adverse events (increased appetite and hand tremor). The main adverse events, found with both treatments, were significant increases in prolactin concentrations and weight gain. With both treatments, increased appetite, flu-like symptoms, headaches, and sedation were the most commonly reported adverse effects. 

Patients with bipolar disorders may benefit from risperidone. This has been observed in an open trial of ten patients with rapid cycling bipolar disorder who were refractory to lithium carbonate, carbamazepine, and valproate eight improved after 6 months of treatment. One patient dropped out through non-adherence to therapy and one because of adverse effects (agitation, anxiety, insomnia, and headache) (5). There was a similar beneficial effect in eight adults with moderate to profound mental retardation (6). Risperidone was associated with a significant reduction in aggression and self-injurious behavior, whereas adverse effects were primarily those of sedation and restlessness. 

In an 8-week open prospective study of risperidone in 20 patients, mean age 34 (range 19-53) years, adverse effects included giddiness (n = 3), headache (n = 2), and agitation (n = 2) one woman reported galactorrhea and another developed obsessive-compulsive symptoms 16 of 20 patients were taking antiparkinsonian drugs before the study, compared with 12 patients at the end (10). 

A 57-year-old woman with no history of hypertension and not taking other medicines began having profuse nose bleeds and headaches immediately after starting t o take risperidone 1 mg/day risperidone was withdrawn 4 days later and the nose bleeds stopped. 

Possible interactions between donepezil and risperidone, which are both metabolized by CYP2D6 and CYP3A4, have been studied (SEDA-26,65) (247). Of 24 healthy men (mean age 40 years) were assigned to risperidone 1 mg/day, donepezil 5 mg/day, or both, 20 reported at least one adverse event, mostly headache, nervousness, or somnolence. However, measures of pharmacokinetics showed no interaction. 

An open comparison of donepezil and risperidone, alone or in combination, in 24 healthy men showed no significant pharmacokinetic differences (88). Adverse events such as headache, nervousness, and somnolence were minor and comparable in all groups. These results suggest that no clinically significant interactions occur between risperidone and donepezil at steady state. However, whether these conclusions can be extrapolated to the elderly patients with dementia, who may eliminate both donepezil and risperidone slowly, is uncertain. 

Risperidone was also effective and well tolerated in 118 children aged 5-12 years with subaverage intelligence and severely disruptive behavior in a 6-week, multicenter, double-blind, randomized trial (7). Risperidone produced significantly greater improvement than placebo on the conduct problem subscale of the Nisonger Child Behavior Rating Form from week 1 (respective reductions in score of 15 and 6). The most common adverse effects of risperidone (mean dose at end-point 1.16 mg/day) were headache and somnolence the extrapyramidal symptom profile of... 

Off-label uses of risperidone have been assessed in two studies. In a double-blind study, elderly patients with depression resistant to citalopram, who had previously responded to adjunctive therapy with risperidone, where randomly allocated to continue with adjunctive therapy with risperidone (modal dose 0.8 mg/day n = 32) or to receive placebo ( = 31) [126 ]. Three patients taking risperidone reported headache. 

A post hoc subgroup analysis of a randomised, double-blind trial of paliperidone palmitate and risperidone microspheres found the most common adverse events with paliperidone palmitate were insomnia, headache and injection site pain, and with risperidone microspheres were insomnia and headache... 

In a 20-week study of bipolar manic patients treated with oral risperidone, the most common adverse events included gastrointestinal disturbances (nausea), weight gain, headaches, somnolence and extrapyramidal symptoms (tremor, unsteady gait, muscle stiffness) 23% of patients gained >7% weight [242 ]. 

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