Risperidone weight gain

Risperidone can be administered once or twice daily in doses ranging from 2 to 6mg/day. Risperidone is well tolerated with comparatively few mild side effects. It can cause drowsiness, weight gain, dizziness, nausea, indigestion, diarrhea, and sexual dysfunction. Finally, risperidone does not increase the risk for agranulocytosis or seizures. 

Despite the widespread use of neuroleptics in maintenance treatment of bipolar disorder, there have not been any systematic studies of their suitability for this role. Through clinical experience it has been widely accepted that neuroleptics are useful adjunctive treatments to lithium and related drugs. Treatment refractory patients frequently respond to atypical antipsychotics such as clozapine or risperidone. Such adverse effects as EPS, cognitive dysfunction and weight gain frequently limit the long-term use of classical neuroleptics. For this reason, the atypical neuroleptics such as olanzapine and risperidone should now be considered as alternatives for maintenance treatment. 

HT2 antagonists like trazodone, nefazodone, clozapine and risperidone are used in the treatment of schizophrenia and depression. They block adrenoceptors and Hi-histamine-receptors as well. Hypotension, drowsiness and weight gain can occur. 

C. M. (1998) Weight gain in adolescents treated with risperidone and conventional antipsychotics over six months. / Child Adolesc Psychopharmacol 8 151—159. 

Martin, A., Landau, J., Leebens, P., Ulizio, K., Cicchetti, D., Scahill, L., and Leckman, J.E (2000) Risperidone-associated weight gain in children and adolescents a retrospective chart review. / Child Adolesc Psychopharmacol 10 235-244. 

Kelly, D.L., Conley, R.C., Love, R.C., Horn D.S., and Ushchak, C.M. (1998) Weight gain in adolescents treated with risperidone and conventional antipsychotics over sixth months. / Child Adolesc Psychopharmacol 8 151-159. 

Atypical antipsychotics cause fewer EPS than do conventional antipsychotics. Clozapine and quetiapine are the least likely to cause EPS and are therefore recommended for treatment of psychosis in patients with Parkinson s disease. With the notable exception of risperidone, atypical antipsychotics cause substantially less hyperprolactinemia than do conventional antipsychotics. Weight gain is a side effect of all atypical antipsychotics except ziprasidone and aripiprazole. Concerns about cardiac conduction delay with ziprasidone therapy exist and warrant consideration in patients who have... 

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. 

J Clin Psychopharmacol 9 71-72, 1989 Henderson DC, Goff DC Risperidone as an adjunct to clozapine therapy in chronic schizophrenics. J Clin Psychiatry 57 395-397, 1996 Henderson DC, Cagliero E, Gray C, et al Clozapine, diabetes mellitus, weight gain, and lipid abnormalities a five year naturalistic study. Am J Psychiatry 157 975-981, 2000... 

Risperidone Mild weight gain, EPS at high doses 2-3 1 mg/day increments 1-6... 

Aripiprazole Blockade of 5HT2A receptors > blockade of D2 receptors Some a blockade (clozapine, risperidone, ziprasidone) and M-receptor blockade (clozapine, olanzapine) variable receptor blockade (all) Schizophrenia—improve both positive and negative symptoms bipolar disorder (olanzapine or risperidone adjunctive with lithium) agitation in Alzheimer s and Parkinson s (low doses) major depression (aripiprazole) Toxicity Agranulocytosis (clozapine), diabetes (clozapine, olanzapine), hypercholesterolemia (clozapine, olanzapine), hyperprolactinemia (risperidone), QT prolongation (ziprasidone), weight gain (clozapine, olanzapine)... 

Risperidone (1) has high affinity for D2, 5-HT2c and tti receptors and a very high affinity for the 5-HT2a receptor. Risperidone is the most likely of the atypical antipsychotics to cause prolactin increases, but has a lower weight gain liability than olanzapine or quetiapine. Risperidone has a relatively narrow therapeutic window since doses above 6 mg/day cause EPS in a dose-dependent manner. 

There has been one comprehensive meta-analysis including over 80 studies and over 30 000 patients (814). A meta-analysis of trials of neuroleptic drugs showed the following mean weight gains in kg after 10 weeks of treatment clozapine, 4.5 olanzapine, 4.2 thioridazine, 3.2 sertindole, 2.9 chlorpromazine, 2.6 risperidone, 2.1 haloperidol, 1.1 fluphenazine, 0.43 ziprasidone 0.04 molindone, —0.39 placebo, —0.74... 

---