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RISPERDAL
(generic name: Risperidone) |
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Reviews |
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Risperdal |
Pharmacopsychiatry. 2005 Mar;38(2):105-6.
Risperidone-associated Transient Diabetic Ketoacidosis
and Diabetes Mellitus Type 1 in a Patient Treated with Valproate and Lithium
- A Case Report.
Mithat B, Alpaslan T, Bulent C, Cengiz T.
Associated Professor, Departments of Endocrinology, University of Dicle,
School of Medicine, Diyarbakir, Turkey.
A 37-year-old man treated with valproate and lithium for bipolar affective
disorder since 1999 and with risperidone since March 2003 was admitted to
our clinic due to metabolic acidosis. Serum glucose was 647 mg/dL and urine
ketones were positive. The patient was accepted as diabetic ketoacidosis
(DKA). Risperidone, valproate, and lithium were immediately stopped, and
the patient was treated with insulin and IV fluid replacement. Serum insulin
and C-peptide levels were too low, and islet cell antibody and anti-GAD
antibody were positive. We accepted him as type 1 diabetes mellitus (DM
type 1). After the intensive treatment of diabetes, insulin requirements
decreased gradually and diabetes mellitus disappeared completely within
three months. Conclusion: Risperidone may lead to transient DM type 1 and
DKA. |
Int J Neuropsychopharmacol. 2005 Mar
01;:1-12.
Clozapine, risperidone, olanzapine, and conventional
antipsychotic drug effects on glucose, lipids, and leptin in schizophrenic
patients.
Smith RC, Lindenmayer JP, Bark N, Warner-Cohen J, Vaidhyanathaswamy
S, Khandat A.
Department of Psychiatry, New York University Medical School, NY, USA.
Some reports have indicated increased rates of diabetes and increased prevalence
of glucose and lipid abnormalities during treatment with second-generation
antipsychotics, with most concern raised about clozapine and olanzapine.
Most of the findings have come from case reports, retrospective examination
of laboratory values, and analysis of health-care claims databases. This
study investigated fasting levels of glucose, lipids, and leptin in a non-randomized,
cross- sectional study of 210 patients, with schizophrenic or schizoaffective
disorder, treated with a single antipsychotic medication - clozapine, risperidone,
olanzapine, or a conventional antipsychotic. Glucose tolerance tests (GTT),
with a 75-g glucose load, were preformed in a subset of patients. In this
sample most mean fasting glucose and lipid levels were within the normal
range and were not significantly different across the four drug treatment
groups. Patients treated with clozapine and olanzapine had higher triglyceride
levels than risperidone patients. In patients receiving a GTT, risperidone-treated
patients had higher glucose levels at 1 h than patients treated with olanzapine,
and there were more patients on risperidone who met American Diabetes Association
glucose metabolic criteria for diagnosis of diabetes. Although there were
no significant differences in age or body mass index among the four drug
groups, we cannot rule out some potential biasing factors we did not assess
which could potentially influence our results. These include unknown physician
preference in drug selection based on their beliefs about the weight-inducing
or diabetes potential of different antipsychotics, differences in visceral
fat, and differences in patients' antipsychotic drug history. |
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Drug information |
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| GENERIC NAME: risperidone
BRAND NAME: Risperdal
DRUG CLASS AND MECHANISM: Risperidone is an antipsychotic
medication that works by interfering with the communication among nerves
in the brain. The nerves communicate with one another by producing and
releasing chemicals called neurotransmitters. The neurotransmitters attach
to receptors on other nearby nerves, and the attachment of the neurotransmitter
causes changes in the cells that have the receptor on them. Risperidone
blocks several of the receptors on nerves including dopamine type 2, serotonin
type 2, and alpha 2 adrenergic receptors and this blocks communication
among nerves. Risperidone is a relatively new antipsychotic medication
that probably has fewer side effects than many of the older medications.
PREPARATIONS: Tablets of 1, 2, 3, and 4 mg.
STORAGE: Tablets should be kept at room temperature,
15-30°C (59-86°F).
PRESCRIBED FOR: Risperidone is used for the treatment
of psychotic disorders, for example, schizophrenia. It also is used in
combination with lithium or valproate for the treatment of acute manic
or mixed episodes associated with bipolar I disorder.
DOSING: Risperidone usually is begun as two small doses
each day. The doses often are increased every few days or each week until
the optimal dose is found. Patients who are elderly or have kidney disease
may need lower doses since the kidneys, which are partially responsible
for removing risperidone from the blood, remove risperidone more slowly,
and this can lead to toxic levels of risperidone in the blood. Similarly,
patients with liver disease may need lower doses since the liver also
is partially responsible for removing risperidone.
DRUG INTERACTIONS: Risperidone may interfere with elimination
by the kidneys of clozapine (Clozaril), a different type of antipsychotic
medication, causing increased levels of clozapine in the blood. This could
increase the risk of side effects with clozapine.
PREGNANCY: There are no adequate studies of risperidone
in pregnant women. Some studies in animals suggest no important effects
on the fetus, whereas others suggest an ill-effect. Risperidone can be
used in pregnancy if the physician feels that the benefits outweigh the
potential but unknown risks.
NURSING MOTHERS: It is not known if risperidone is secreted
in breast milk.
SIDE EFFECTS: The most commonly noted side effects associated
with risperidone are extrapyramidal effects (sudden, often jerky, involuntary
motions of the head, neck, arms, body, or eyes), dizziness, hyperactivity,
tiredness, and nausea. Risperidone may cause a condition called orthostatic
hypotension during the early phase of treatment (the first week or two).
Patients who develop orthostatic hypotension have a drop in their blood
pressure when they rise from a lying position and may become dizzy.
Although there is no clear link between risperidone and diabetes, patients
should be tested during treatment for elevated blood-sugars. Additionally,
persons with risk factors for diabetes, including obesity or a family
history of diabetes, should have their fasting levels of blood sugar tested
before starting treatment and periodically throughout treatment to detect
the onset of diabetes. Any patient developing symptoms that suggest diabetes
during treatment should be tested for diabetes.
Caution! Before starting
to take this medicine, it is vital that you should consult your doctor!
Do not use it on your own initiative, without medical advice.
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Order now ! |
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RISPERDAL
Substance: Risperidone
Manufacturer: Johnson & Johnson
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Dosage |
Packing |
Price |
Pay now |
1 mg |
60 tab |
USD 129.00 |
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2 mg |
60 tab |
USD 198.00 |
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3 mg |
60 tab |
USD 257.00 |
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4 mg |
60 tab |
USD 299.00 |
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