Optimal Dosing With Risperidone: Updated Recommendations

Background: Drug dosages utilized duringcontrolled clinical trials are not always optimal for patientsencountered in day-to-day practice. The original trials ofrisperidone, a novel antipsychotic, suggested that an initialtarget dose of 6 mg/day was appropriate, but these trials werenecessarily conducted among patients who were chronicallyimpaired, hospitalized, and often partly drug resistant.

Data Sources: Relevant data relating to thedosage of risperidone identified through an online (MEDLINE)search using the keywords risperidone, schizophrenia,schizoaffective disorder, dementia, bipolardisorder, and dose were supplemented by a review ofinternational and U.S. Congress abstracts in which the dose ofrisperidone was specifically described.

Conclusion: On the basis of naturalisticstudies, clinical audit, phase 4 trials, positron emissiontomography data, and 5 years of clinical experience, thecurrently recommended target dose of risperidone is 4 mg/day formost patients, with less-rapid titration than previouslyrecommended. Moreover, a lower dose than this and slowertitration may be appropriate for elderly patients, youngpatients, and first-episode patients.