Tremor risperidone

A 53-year-old man took paroxetine 40 mg/day and risperidone 6 mg/day, having previously taken lower doses of both. Within 2 hours he developed ataxia, shivering, and tremor. He had profound sweating but was apyrexial, and was confused, with involuntary jerking movements of his limbs. He recovered without specific treatment over the next 2 days. 

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. 

The medical records of 151 hospitalized elderly psychiatric patients (mean age 71 years) have been analysed (8). Of 114 patients treated with risperidone (mean duration of treatment 17 days mean dose 3 mg/day), 78% responded. Adverse events were reported in 20 patients, including new-onset extrapyramidal effects in four tremor in four sedation in three hypotension in three diarrhea in two tardive dyskinesia in two and chest pain, anxiety, restlessness, itching, insomnia, and falls in one each. 

There was marked reduction in aggression in 14 of 26 subjects (10-18 years old) in an open study of risperidone (0.5 1 mg/day) for 2-12 months (17). Two subjects had marked weight gain (8 and 10 kg) in the first 8 weeks another participant who took lithium (1400 mg/day, serum concentration 0.9 mmol/1) presented with moderate akathisia and hand tremor in seven, tiredness and sedation occurred after week 8. 

Risperidone has also been used in combination with topiramate in a Spanish multicenter study in 58 patients (28 men and 30 women mean age 41 years) with bipolar I disorder, with manic but not mixed episodes (20). Risperidone (mean dose 2.7 mg/day) and topiramate (mean dose 236 mg/day) were started with a maximum 48-hour time difference risperidone was used for acute manic symptoms and topiramate for longer-term stabilization and prevention of relapse. The incidence of any adverse event was 64%, mostly somnolence, paresthesia, dizziness, tremor, weight loss (n = 27 mean change -1.1 kg), extrapyramidal disorders, gastrointestinal effects, and cognitive disturbances. One patient developed tardive dyskinesia during the study and there were five dropouts because of adverse effects adverse effects that required withdrawal of risperidone but not topiramate were amenorrhea (n = 3) and sexual dysfunction (n = 1). 

A 32-year-old man who had been taking olanzapine 15 mg/day for 4 months was switched to injectable risperidone 25 mg because of poor adherence. On the next day he had an oculogyric crisis, dysarthria, torticollis, dysphagia, tremor, and rigidity, which resolved with procyclidine. 

Intolerable exacerbation of parkinsonism with risperidone has been reported (SEDA-20, 52), and even a 12-year-old boy reportedly developed parkinsonian tremor while taking risperidone (76). However, in contrast, eight patients (five women, three men) with advanced Parkinson s disease, motor fluctuations, and levodopa-induced dyskinesia took part in an open study with a low dosage of risperidone (mean 0.187 mg/day) after an average of 11 months all the patients had moderate to pronounced reductions in levodopa-induced dyskinesias (77). 

A 24-year-old woman with mental retardation and an unspecified psychosis took risperidone 2 mg/day and trihexyphenidyl 2 mg/day and after 2 weeks developed symptoms that included tilting of her body backwards and to the left and tremors and cogwheel rigidity of the limbs (101). Risperidone was withdrawn and olanzapine 5 mg/day started after 4 weeks there was no improvement and she was then lost to follow-up. 

A 34-year-old man with AIDS took risperidone 4 mg/ day for a Tourette-like tic disorder. Ritonavir and indinavir were added, and 1 week later he developed significantly impaired swallowing, speaking, and breathing, and worsening of his existing tremors. 

A 53-year-old man with no past psychiatric history was found by the police walking aimlessly, unclothed, and responding to auditory hallucinations (545). He had slurred speech and generalized tremors. Lumbar puncture, a CT head scan, and urine drug screen were all normal. He responded to risperidone 1 mg bd with dramatic improvement after 2 days. He reported chronic use of nalbuphine, with recent increased use. 

Reversible dementia occurred in a patient with multiple myeloma taking thalidomide 200 mg/day plus dexa-methasone (59). Memory deficit and mania occurred about 2 months after the start of therapy and did not resolve on withdrawal of dexamethasone and administration of risperidone. The memory loss worsened and proceeded to disorientation, apraxia, and tremor 4 months after the start of therapy. The dementia... 

Worsening of side-effects such as slowness, stiffness and tremor, t blood levels. A single case report of priapism induced by a ginkgo-risperidone combination. Hyperthermia... 

Risperidone and blonanserin In a randomised comparison of risperidone and blonanserin in 206 patients with schizophrenia the mean change in the Positive and Negative Syndrome Scale (PANSS) total score at the final evaluation time point was —24 with blonanserin and -25 with risperidone [125 ]. Dysarthria, dizziness, increased alanine aminotransferase and aspartate aminotransferase activities, and increased blood prolactin concentrations were more frequent with risperidone hand tremor was more frequent with blonanserin. 

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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