Risperidone - Revision history

MDElliottMD: home-claude: fix CPIC citation hard errors (CPIC scope does not cover these medicines; correct to PharmGKB/DPWG/FDA label where applicable)

2026-05-27T02:23:05Z

home-claude: fix CPIC citation hard errors (CPIC scope does not cover these medicines; correct to PharmGKB/DPWG/FDA label where applicable)

← Older revision		Revision as of 02:23, 27 May 2026
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	\| pregnancy = Signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.{{citation needed}}		\| pregnancy = Signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.{{citation needed}}
	\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly patients with dementia-related psychosis<ref name="risperdal-label" />		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly patients with dementia-related psychosis<ref name="risperdal-label" />
	\| mechanism = <vote slug="risperidone-mech-claim">'''D2 dopamine receptor antagonist plus 5-HT2A serotonin receptor antagonist''', the classical atypical-neuroleptic signature originally derived from clozapine but with a more dopamine-tilted occupancy profile than olanzapine or quetiapine. The high D2 occupancy at therapeutic doses produces the highest rates of '''hyperprolactinemia''' among second-generation neuroleptics (galactorrhea, amenorrhea, sexual dysfunction, and bone density loss with chronic use), along with dose-dependent extrapyramidal symptoms above ~6 mg/day.</vote> CYP2D6 substrate; CYP2D6 poor metabolizers have higher ~~plasma~~ exposure ~~and may benefit from lower initial dosing~~. ~~CPIC PGx guidance applies~~<ref name="~~cpic~~-~~cyp2d6~~">~~CPIC Guideline~~ for CYP2D6 ~~Genotype~~ and ~~Neuroleptic Dosing~~. ~~https~~:~~//cpicpgx~~.org~~/guidelines/</ref~~>.		\| mechanism = <vote slug="risperidone-mech-claim">'''D2 dopamine receptor antagonist plus 5-HT2A serotonin receptor antagonist''', the classical atypical-neuroleptic signature originally derived from clozapine but with a more dopamine-tilted occupancy profile than olanzapine or quetiapine. The high D2 occupancy at therapeutic doses produces the highest rates of '''hyperprolactinemia''' among second-generation neuroleptics (galactorrhea, amenorrhea, sexual dysfunction, and bone density loss with chronic use), along with dose-dependent extrapyramidal symptoms above ~6 mg/day.</vote> CYP2D6 substrate; CYP2D6 oxidation produces 9-hydroxy-risperidone (paliperidone). CYP2D6 poor metabolizers have higher risperidone exposure, but the active-moiety sum (risperidone plus paliperidone) is relatively preserved across CYP2D6 phenotypes.<ref name="risperdal-label" /> PharmGKB clinical annotations for risperidone-CYP2D6 apply (Level 2A) and the Dutch Pharmacogenetics Working Group (DPWG) has issued CYP2D6 dosing guidance for risperidone.<!-- citation needed: PharmGKB risperidone CYP2D6 annotation Level 2A; DPWG risperidone CYP2D6 dosing guidance. Search: pharmgkb.org risperidone; dpwg risperidone cyp2d6 --> No formal CPIC guideline for neuroleptic CYP2D6 dosing has been published.
	}}		}}

MDElliottMD: parser-claude: Risperidone MedTemplate refill, Top 300 stub upgrade

2026-05-23T07:14:48Z

parser-claude: Risperidone MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 07:14, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Risperidone		\| generic = Risperidone
	\| brand = Risperdal		\| brand = Risperdal (oral), Risperdal M-Tab (ODT), Risperdal Consta (biweekly IM LAI), Perseris (monthly SC LAI), Uzedy (monthly/bimonthly SC LAI), Rykindo (biweekly IM LAI)
	\| structure =		\| structure =
	\| classes = ~~Antipsychotic~~, ~~Neuroleptic~~		\| classes = [[:Category:Neuroleptics\|Neuroleptic]], [[:Category:Atypical neuroleptics\|Atypical neuroleptic (second-generation)]], [[:Category:Benzisoxazoles\|Benzisoxazole]], [[:Category:Mood stabilizers\|Mood stabilizer]]
	\| ~~mechanism~~ = D2/5-~~HT2A antagonist~~		\| uses = <vote slug="schizophrenia-use">Schizophrenia (FDA)</vote>, <vote slug="bipolar-mania-mixed-use">Bipolar I mania and mixed episodes (FDA)</vote>, <vote slug="autism-irritability-pediatric-use">Autism spectrum disorder-associated irritability (FDA, pediatric ages 5+)</vote>, <vote slug="schizoaffective-disorder-use">Schizoaffective disorder (off-label)</vote>, <vote slug="severe-agitation-dementia-use">Severe agitation in dementia (off-label; with mortality-warning caveats)</vote>
	\| ~~uses~~ =		\| starting_dose = Schizophrenia / mania: 1 mg PO BID, titrate to 4-8 mg/day. Pediatric autism irritability: 0.25-0.5 mg/day, weight-titrated. Consta LAI: 25 mg IM every 2 weeks after oral overlap
	\| ~~starting_dose~~ =		\| preparations = Tablets 0.25, 0.5, 1, 2, 3, 4 mg; M-Tab ODT 0.5, 1, 2, 3, 4 mg; oral solution 1 mg/mL; Consta LAI 12.5, 25, 37.5, 50 mg; Perseris SC LAI 90, 120 mg monthly
	\| ~~preparations~~ =		\| fda_max = 16 mg/day (schizophrenia, adult); 6 mg/day (bipolar maintenance, autism irritability)
	\| ~~fda_max~~ =		\| pill_id =
	\| routes =		\| routes = Oral, intramuscular (LAI), subcutaneous (LAI)
	\| onset =		\| onset = Neuroleptic effect emerges over days to weeks
	\| duration =		\| duration = 24 hours (oral); 2-4 weeks (LAI formulations)
	\| halflife =		\| halflife = Risperidone 3-20 hours; '''9-hydroxy-risperidone (paliperidone) ~20-24 hours''' is the major active metabolite and is separately marketed as a parent compound (Invega)<ref name="risperdal-label">FDA Prescribing Information, Risperdal (risperidone), Janssen, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020272s068,020588s053,021444s041lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~70% (oral)<ref name="risperdal-label" />
	~~\| pregnancy~~ =		\| pregnancy = Signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly patients with dementia-related psychosis<ref name="risperdal-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="risperidone-mech-claim">'''D2 dopamine receptor antagonist plus 5-HT2A serotonin receptor antagonist''', the classical atypical-neuroleptic signature originally derived from clozapine but with a more dopamine-tilted occupancy profile than olanzapine or quetiapine. The high D2 occupancy at therapeutic doses produces the highest rates of '''hyperprolactinemia''' among second-generation neuroleptics (galactorrhea, amenorrhea, sexual dysfunction, and bone density loss with chronic use), along with dose-dependent extrapyramidal symptoms above ~6 mg/day.</vote> CYP2D6 substrate; CYP2D6 poor metabolizers have higher plasma exposure and may benefit from lower initial dosing. CPIC PGx guidance applies<ref name="cpic-cyp2d6">CPIC Guideline for CYP2D6 Genotype and Neuroleptic Dosing. https://cpicpgx.org/guidelines/</ref>.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects~~ =
	~~\| interactions = <pharmaInteractions~~/>
	\| ~~pregnancy_details =~~
	~~\| monitoring~~ =
	~~\| counseling~~ =
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

	~~[[Category:Second-generation neuroleptics]]~~		== References ==
			<references />

	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]
			[[Category:Atypical neuroleptics]]
			[[Category:Benzisoxazoles]]
			[[Category:Mood stabilizers]]

MDElliottMD: Category taxonomy (#23): retag to house-compliant neuroleptic categories

2026-05-22T14:41:30Z

Category taxonomy (#23): retag to house-compliant neuroleptic categories

← Older revision		Revision as of 14:41, 22 May 2026
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	}}		}}

	[[Category:Second-~~Generation Antipsychotics (SGAs / Atypicals)~~]]		[[Category:Second-generation neuroleptics]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

2026-05-19T18:00:18Z

Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	}}		}}


	~~[[Category:Antipsychotics / Neuroleptics]]~~
	[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]		[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:51Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Antipsychotics / Neuroleptics]]
			[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:08Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:49Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:40Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Risperidone
+| generic            = Risperidone
-| brand             = Risperdal
+| brand              = Risperdal
-| classes           = Antipsychotic, Neuroleptic
+| structure          =
-| mechanism         = D2/5-HT2A antagonist
+| classes            = Antipsychotic, Neuroleptic
 }}
 [[Category:Neuroleptics]]

MDElliottMD: Auto-created stub

2026-05-13T00:00:00Z

Auto-created stub

New page

{{MedTemplate
| generic = Risperidone
| brand = Risperdal
| classes = Antipsychotic, Neuroleptic
| mechanism = D2/5-HT2A antagonist
}}
[[Category:Neuroleptics]]