Risperidone Risks, Warnings, and Complications

INCREASED RISK OF STROKE AND DEATH: Antipsychotic medications like risperidone can put elderly patients with dementia-related psychosis at a higher risk of stroke and death. Risperidone is not used to treat mental health conditions like dementia-related psychosis.

NEUROLEPTIC MALIGNANT SYNDROME: Very rarely, risperidone can lead to a serious brain disorder called neuroleptic malignant syndrome. Signs and symptoms of this condition include high fever, muscle stiffness, excessive sweating, confusion, and changes in heart rate and  blood pressure. Get medical help right away if you experience these symptoms as they can be life-threatening. 

TARDIVE DYSKINESIA: Risperidone can lead to a movement disorder called tardive dyskinesia in which there are extrapyramidal symptoms (uncontrolled movements of the face, tongue, and other parts of the body). Other symptoms may include fidgeting, restlessness, shakiness, and muscle stiffness. Tell your doctor right away if you notice any restlessness or unusual movements. The risk is higher with larger doses of risperidone and long-term use of this medicine.

HIGH BLOOD GLUCOSE, HIGH CHOLESTEROL, AND WEIGHT GAIN: Risperidone can cause an increase in your blood sugar and cholesterol levels. It can also lead to an increase in appetite and weight gain. Your doctor may order blood tests to make sure you don’t have high blood sugar or high cholesterol before starting you on risperidone. The risk of these complications is higher in people who are obese, those with a personal or family history of diabetes, and those who already have high cholesterol.

DECREASE IN WHITE BLOOD CELL COUNT: Risperidone can lead to a drop in the number of white blood cells in your blood. These cells help the body fight infections. Tell your doctor right away if you develop a fever or find that you are falling sick or catching infections more easily. Your healthcare professional may order a blood test before starting you on this medicine and during the first few months of treatment to keep an eye on your white blood cell count. 

SEIZURES: Risperidone can increase the likelihood of having seizures. People with a history or seizures or other health conditions that can cause seizures are at higher risk. Tell your doctor about any history of seizures before starting risperidone.

DECREASED THINKING ABILITY: This medicine affects your ability to concentrate, focus, think, and react. Avoid doing activities that require you to be fully alert, such as driving a car or operating machinery, until you know how risperidone affects you.

LOW BLOOD PRESSURE: Risperidone can lead to a sudden fall in blood pressure, which can cause dizziness and increase your risk of falls and injuries. Be sure to go slowly from a sitting or lying position to standing until your body gets used to the medicine. Risk factors include a history of stroke or heart disease, taking medications for high blood pressure, and dehydration. 

DIFFICULTY SWALLOWING: Taking risperidone can make it harder to swallow foods and drinks. This can potentially cause these substances to enter your lungs and cause problems with breathing. Be sure to chew food completely and swallow drinks carefully. Tell your healthcare provider if you notice any problems with swallowing or tightening in the throat area. Older adults with Alzheimer’s dementia are at particularly high risk. 

DIFFICULTY WITH REGULATING BODY TEMPERATURE: Risperidone can make it harder for the body to regulate its temperature. As a result, you may not be able to cool down in hot weather or warm up in cold weather. Monitor your body temperature carefully when you’re exposed to extreme outside temperatures while on risperidone.

PAINFUL OR PROLONGED ERECTION: Risperidone can cause a painful erection that lasts for several hours. This is an emergency. You should seek immediate medical care if you have an erection that is painful or does not go away. In severe cases, doctors may need to perform surgery to prevent permanent damage to the penis. 

RISK TO PEOPLE WITH PHENYLKETONURIA: The orally disintegrating tablets of risperidone contain an amino acid called phenylalanine. Some people with a rare but serious condition called phenylketonuria are unable to break down this amino acid. High levels of phenylalanine can cause symptoms like shaking, seizures, behavioral problems, and musty-smelling urine, skin, and breath. Tell your healthcare provider if you have phenylketonuria before starting risperidone. 

INCREASED PROLACTIN LEVELS: Risperidone can lead to an increase in prolactin levels. High levels of this hormone can cause fertility problems, enlargement of male breasts, absent or irregular menstrual periods in females, sexual dysfunction, and weakening of the bones. Your healthcare provider may order blood tests on a regular basis to keep an eye on your prolactin levels.

POTENTIAL HARM TO NEWBORN BABIES: Taking risperidone during the third trimester of pregnancy can increase the risk of withdrawal symptoms in a newborn baby after delivery. Talk to your doctor about the risk of taking risperidone if you are pregnant or planning a pregnancy.