Some warnings and precautions to be aware of with risperidone include:
The U.S. Food and Drug Administration (FDA) has issued a special warning (a "black box warning") about the use of risperidone in elderly people with dementia (a condition involving confusion; disorientation; and a loss of memory, intellect, and judgment) or psychosis. Elderly people with dementia (Alzheimer's disease is the most common form of dementia) who are treated with antipsychotics -- including risperidone -- are more likely to die (of various causes) than those who were not treated with those medications. Risperidone is not approved to treat dementia or dementia-related psychosis, and caution should be used before using risperidone in elderly people with dementia.
Risperidone can cause tardive dyskinesia, a condition involving unusual and uncontrollable body or face movements. The condition can become permanent (even if risperidone is stopped). The best way to prevent it from becoming permanent is to tell your healthcare provider right away if you notice any abnormal movements (including abnormal movements of the tongue) while taking risperidone.
Risperidone can cause an increase in blood sugar levels and can increase the risk of developing diabetes. Tell your healthcare provider if you develop signs of diabetes while taking risperidone. Possible signs of diabetes can include increased thirst, increased urination, or hunger. If you have diabetes, your blood sugar should be monitored carefully and regularly during treatment with risperidone to make sure your diabetes is not becoming more severe (see Risperdal and Diabetes).
Risperidone can cause a drop in blood pressure when going from a sitting or lying position to standing (known medically as orthostatic hypotension). This can cause lightheadedness, dizziness, or fainting. Tell your healthcare provider if you have any of these symptoms when standing. Orthostatic hypotension can be especially dangerous in people with heart disease or congestive heart failure (CHF).
Risperidone may increase the risk of seizures. Before starting risperidone, tell your healthcare provider if you have epilepsy or a history of seizures.
Risperidone can cause difficultly swallowing, which can lead to inhalation of food (potentially causing pneumonia). Tell your healthcare provider if you notice any problems swallowing.
Risperidone can cause high levels of the hormone prolactin. Let your healthcare provider know if you develop signs of high prolactin, such as breast enlargement or breast discharge.
Very rarely, risperidone can cause priapism (a painful erection of the penis that does not go away). Since this is a medical emergency, seek medical care immediately (to prevent permanent damage to the penis).
If you have liver or kidney disease, talk to your healthcare provider before taking risperidone.
People with Parkinson's disease may be more sensitive to the effects of risperidone. Be sure to discuss this with your healthcare provider.
Risperidone is considered a pregnancy Category C medication. This means that it may not be safe to take risperidone during pregnancy. Be sure to talk with your healthcare provider about the risks and benefits of using risperidone during pregnancy (see Risperdal and Pregnancy).
Risperidone passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using risperidone (see Risperdal and Breastfeeding for more information).
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