Risperidone oral

Risperidone oral solution is not compatible with cola or tea... 

Immunologic A case of peripheral oedema associated with risperidone oral solution has been described [269 ]. A case of angioedema periorbital oedema, swelling over the face, dyspnoea, dysphagia) in a 45-year-old woman 3 days after receiving her first injection of risperidone microspheres is reported [270 ]. 

Yang HN, Cheng YM. Peripheral edema associated with risperidone oral solution a case report and a review of the literature. J Clin Psychopharmacol 2012 32(l) 128-30. 

Patients seen for flashbacks are treated with oral diazepam (15—30 mg/day for adults) if symptoms of anxiety are severe (Rumack 1987). Neuroleptics, especially haloperidol, have been implicated in a transient increase in visual flashbacks and are not recommended (Moskowitz 1971 Strassman 1984). Risperidone and selective serotonin reuptake inhibitors may also worsen symptoms of hallucinogen persisting perception disorder (Halpern and Pope 2003). The patient needs assurance of the self-limiting nature of the phenomenon and its decreasing frequency of reoccurrence with time. The patient should be reminded that any future use of hallucinogens or marijuana may precipitate similar symptoms (Strassman 1984). 

Difficulty swallowing tablets/capsules Risperidone or aripiprazole liquid, orally-disintegrating tablets (risperidone, olanzapine, clozapine) Long-acting risperidone... 

Injection - For patients who have never taken oral risperidone, establish tolerability with oral risperidone prior to initiating treatment with injectable risperidone. 

The recommended dose is 25 mg IM every 2 weeks. Some patients not responding to 25 mg may benefit from a higher dose of 37.5 or 50 mg. The maximum dose should not exceed risperidone injection 50 mg every 2 weeks. Give oral risperidone or another antipsychotic medication with the first risperidone injection and continue for 3 weeks (then discontinue) to ensure that adequate therapeutic plasma concentrations are maintained prior to the main release phase of risperidone from the injection site. 

Renal/Hepatic function impairment-Treat with titrated doses of oral risperidone prior to initiating treatment with risperidone injection. The recommended starting dose is oral risperidone 0.5 mg twice daily during the... 

Reinitiation of treatment - Wnen restarting patients who have had an interval off treatment with risperidone injection, supplement with oral risperidone or another antipsychotic medication. 

Topiramate may affect alcohol, amitriptyline, CNS depressants, lithium, oral contraceptives, digoxin, estrogens, hydantoins, metformin, risperidone, and valproic acid. 

In the Expert Consensus survey (Rush and Frances, 2000) the expert clinicians rated newer atypical antipsychotics highest for treatment of schizophrenic patients who are compliant with medication. Risperidone was rated highest of the atypicals, followed by olanzapine. In the case of patients with numerous failed trials with other antipsychotics, the experts voted for clozapine. For patients noncompliant with oral medication, respondents endorsed long-acting depot antipsychotics. Once again, these were impressions based on personal clinical experiences rather than hard empirical data. 

For patients with chronic psychotic symptoms who do not comply with a daily medication regimen, a long-acting depot preparation should be considered after stabilization with oral medication. Fluphenazine, haloperidol, and risperidone are the only long-acting injectable antipsychotic medications currently available in the United States. 

Estradiol and progesterone (used in oral contraceptives) reduce specific CYP enzyme activity (e.g., levels of APs such as HPDL, clozapine, and risperidone may rise). 

Nyberg and colleagues (72) were the first to demonstrate that risperidone induces marked occupancy of central 5-HT2 and D2 receptors in vivc. About 60% (range, 45% to 68%) of the 5-HT2 receptors in the frontal cortex and about 50% (range, 40% to 64%) of the D 2 receptors in the striatum were occupied 4 and 7 hours, respectively, after a single oral dose of 1 mg. These results indicate that 5-HT 2 receptor occupancy should be very high at doses of 4 to 10 mg daily. 

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