Risperidone

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Also indexed as:

Risperdal

Risperidone is used to manage symptoms associated with psychotic disorders, especially schizophrenia.

Herbs

Summary of Interactions for Risperidone

Depletion or interference	None known
Adverse interaction	None known
Side effect reduction/prevention	Vitamin B6 Vitamin E
Supportive interaction	Glycine
Reduced drug absorption/bioavailability	None known
Other (see text)	Licorice White peony

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

Vitamin E and Vitamin B6

Vitamin E along with vitamin B6 was used to treat a side effect of risperidone called neuroleptic malignant syndrome in a 74-year-old woman, and results were encouraging.¹ However, whether vitamin E and vitamin B6 supplementation might help prevent this condition in people taking risperidone is unknown.

Glycine

In a small double-blind study, people with schizophrenia being treated with risperidone experienced an improvement in their symptoms when glycine was added to their treatment regimen.² The initial amount of glycine used was 4 grams per day; this was increased gradually over a period of 10 to 17 days to a maximum of 0.8 grams per 2.2 pounds of body weight per day.

Lithium

Lithium is a mineral present in large amounts in some medications, and may be included in some mineral supplements. The combination of lithium and risperidone has produced unwanted side effects such as delirium, confusion, and fever.^{3, 4} Smaller amounts of lithium are available in some nutritional supplements, but it is not known whether these amounts are enough to cause a problem in individuals taking risperidone.

Interactions with Herbs

Licorice (Glycyrrhiza radix) and White peony (Paeoniae radix)

An Oriental herb formula containing Glycyrrhiza radix (licorice root) and Paeoniae radix (white peony root) successfully restored menses in a 28-year-old woman who had developed amenorrhea (lack of menstruation) while taking risperidone.⁵ Discontinuation of these herbs while the woman continued taking risperidone again led to disruption of her menses. In another study, treatment with this same formula restored menses in 6 of 18 women who had developed amenorrhea or oligomenorrhea (infrequent menstruation) from taking risperidone.⁶ Controlled research is needed to determine whether supplementation with licorice and peony might help prevent amenorrhea in women taking risperidone.

Other Interactions

Food

Risperidone oral solution should be mixed in half a glass of water, coffee, orange juice, or low-fat milk and immediately consumed.⁷ It should not be mixed with cola or tea.⁸

Alcohol

Alcohol increases the breakdown of many antipsychotic drugs.⁹ More research is necessary to determine if alcohol consumption might lower blood levels of risperidone.

References

1. Dursun SM, Oluboka OJ, Devarajan S, Kutcher SP. High-dose vitamin E plus vitamin B6 treatment of risperidone-related neuroleptic malignant syndrome. J Psychopharmacol 1998;12:220-1.
2. Heresco-Levy U, Ermilov M, Lichtenberg P, et al. High-dose glycine added to olanzapine and risperidone for the treatment of schizophrenia. Biol Psychiatry 2004;55:165-71.
3. Chen B, Cardasis W. Delirium induced by lithium and risperidone combination. Am J Psychiatry 1996;153:1233-4.
4. Swanson CL Jr., Price WA, McEvoy JP. Effects of concomitant risperidone and lithium treatment (letter). Am J Psychiatry 1995;152:1096.
5. Yamada K, Kanba S, Yagi G, Asai M. Herbal medicine (shakuyaku-kanzo-to) in the treatment of risperidone-induced amenorrhea. J Clin Psychopharmacol 1999;19:380-1.
6. Yuan HN, Wang CY, Sze CW, et al. A randomized, crossover comparison of herbal medicine and bromocriptine against risperidone-induced hyperprolactinemia in patients with schizophrenia. J Clin Psychopharmacol 2008;28:264-70.
7. Threlkeld DS, ed. Central Nervous System Drugs, Antipsychotic Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1998, 267f-8.
8. Threlkeld DS, ed. Central Nervous System Drugs, Antipsychotic Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1998, 267f-8.
9. Ereshefsky L. Pharmacologic and pharmacokinetic considerations in choosing an antipsychotic. J Clin Psychiatry 1999;60 Suppl. 10:20-30.

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Last Review: 01-21-2009

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires February 2010.

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