Optimal Dosing With Risperidone: Updated Recommendations
J Clin Psychiatry 2001;62(4):282-289
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Drug dosages utilized during
controlled clinical trials are not always optimal for patients
encountered in day-to-day practice. The original trials of
risperidone, a novel antipsychotic, suggested that an initial
target dose of 6 mg/day was appropriate, but these trials were
necessarily conducted among patients who were chronically
impaired, hospitalized, and often partly drug resistant.
Data Sources: Relevant data relating to the
dosage of risperidone identified through an online (MEDLINE)
search using the keywords risperidone, schizophrenia,
schizoaffective disorder, dementia, bipolar
disorder, and dose were supplemented by a review of
international and U.S. Congress abstracts in which the dose of
risperidone was specifically described.
Conclusion: On the basis of naturalistic
studies, clinical audit, phase 4 trials, positron emission
tomography data, and 5 years of clinical experience, the
currently recommended target dose of risperidone is 4 mg/day for
most patients, with less-rapid titration than previously
recommended. Moreover, a lower dose than this and slower
titration may be appropriate for elderly patients, young
patients, and first-episode patients.