";s:4:"text";s:5481:" It shouldn’t be used in this age group.NMS is a rare but serious condition that can happen in people who take antipsychotic drugs, including risperidone. Healthline Media does not provide medical advice, diagnosis, or treatment. At the first sign of a clinically significant decline in white blood cells, discontinuation of atypical antipsychotic therapy should be considered in the absence of other causative factors, and the patient closely monitored for fever or other signs and symptoms of infection.Moderate Potential Hazard, Moderate plausibility.
Applies to: Hypokalemia, Diarrhea, Magnesium Imbalance, Abnormal Electrocardiogram, Electrolyte AbnormalitiesRisperidone and its active metabolite, 9-hydroxyrisperidone, can prolong the QT interval of the electrocardiogram in some patients.
Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Applies to: Neuroleptic Malignant SyndromeThe central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). You should not need a new prescription for this medication to be refilled.
Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease).
Although the pharmacokinetics of risperidone do not seem to be significantly altered in patients with liver disease, the mean free fraction of risperidone in plasma has been shown to increase by about 35% because of the diminished concentration of both albumin and alpha1-acid glycoprotein. These issues include:Some insurance companies require a prior authorization for this drug. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of risperidone on the QT interval and should be corrected prior to institution of risperidone therapy. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Applies to: Breast Cancer, HyperprolactinemiaThe chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors.
Caution is also advised in patients with preexisting hyperprolactinemia. Applies to: Priapism, Peyronie's Disease, Sickle Cell Anemia, Thalassemia, Multiple Myeloma, LeukemiaAtypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. It shouldn’t be used in this age group.Your doctor may give you a lower starting dosage of 0.5 mg taken twice per day.
Applies to: DementiaElderly patients with dementia- related psychosis treated with antipsychotic drugs are at an increased risk of death, mostly from cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) causes.
Patients with diabetes should be monitored for worsening control of blood glucose when treated with these agents. These conditions often make worse the quality of life and also lead to longer hospitalizations and higher mortality. Applies to: Hypotension, Dehydration, Diarrhea, Vomiting, Syncope, Ischemic Heart Disease, Congestive Heart Failure, History - Myocardial Infarction, Arrhythmias, Cerebrovascular InsufficiencyThe use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Over the past decades, some hypotheses have tried to explain the connection between CKD and neuropsychiatric disorders. If TD occurs during neuroleptic therapy, prompt withdrawal of the offending agent or at least a lowering of the dosage should be considered. These agents are not recommended in patients with severe renal impairment.Moderate Potential Hazard, Moderate plausibility.
In patients with preexisting drug-induced TD, initiating or increasing the dosage of neuroleptic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. An interaction is when a substance changes the way a drug works.
Applies to: Altered Consciousness, Respiratory ArrestThe use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression.