Pharmacology of Risperidone

The choice of the appropriate anti-psychotic agent is a critical decision in both adult psychiatry and primary care. The decision does not only involve the selection of the most potent therapy but also that which has minimal adverse effects. The development of second generation antipsychotics (also known as atypical antipsychotics) has solved part of this decision since their reduced tendency to generate extra-pyramidal side effects (EPSEs – e.g. akathisia and acute dystonic reactions), makes them more desirable than the first generation drugs. (1,2). Such improved tolerability profiles of second generation antipsychotics (SGAs) compared to the first generation drugs, has lead to their increasing use in the treatment of psychosis as first line agents. (1,2).

Irrespective of this advancement, the second aspect of the decision – the efficacy of the medication – remains a critical factor for consideration. Even within the SGA class the clinical efficacy has been reported to vary among candidates as assessed via meta-analysis tool (1). For instance Davis et al. (2003) suggested clozapine to have the largest effect size with amisulpiride and risperidone following respectively. (cited by 1, table 1, p30). Risperidone is a widely employed SGA in treatment of schizophrenia and other adult psychotic disorders and probably the most commonly employed atypical antipsychotic within the paediatric applications (e.g. in autism associated behavioural difficulties). (3). This paper presents various pharmacological aspects of risperidone.

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