Risperdal or its generic risperidone was the second atypical antipsychotic drug marketed in the United States. Originally prescribed for schizophrenia, manufacturers now focus on mania associated with the bipolar disorder and irritability in autistic children. Other drugs in this category include Abilify, Zyprexa, Seroquel, Latuda, Geodon, Invega, Vraylar and Rexulti.
Off label use of Risperdal is increasingly common. Doctors now prescribe it for anxiety, depression, tics, anxiety, behavioral problems, eating disorders, borderline personality disorder and even insomnia. As many as 1 in 5 seniors in nursing homes receive an atypical antipsychotic. Prescriptions to children appear distressingly common.
Risperdal may result in a wide variety of potentially serious and long lasting complications. Among the problems are nausea, vomiting, diarrhea, constipation, abdominal pain and indigestion. Dry mouth, back pain, difficult sleeping, decreased libido and blurred vision may appear. More serious are tiredness, somnolence and impaired judgment or thinking.
Parkinson like rigidity and gait disturbances are not uncommon. Breast tissue enlargement or gynecomastia may develop in young boys. People may gain weight and develop diabetes as a result of Risperdal. A decline in blood pressure upon standing often lead to dizziness, fainting and falls. Seizures and decreased production of white blood cells by the marrow are other problems sometimes associated with therapy.
An involuntary, repetitive movement of muscles involving the brows, lips, mouth, tongue or extremities becomes increasingly frequent in parallel with the dose and duration of therapy. Known as tardive dyskinesia this well known complication of antipsychotics affects up to 5% at 1 year and 25% after 5 years. Unfortunately it rarely resolves even after discontinuing therapy.
Between 2011-2018 the FDA Adverse Reporting Database received notice of 3691 deaths in people taking Risperdal with the overall number of serious reactions in excess of 37,000. Estimates suggest the FDA receives notice of fewer than 1 out of every 10 adverse drug reactions. While inclusion on the list does not necessarily imply cause and effect, the numbers are sobering.
Drug companies sponsor most of the literature and medical reports dealing with drugs. Obviously these published studies accentuate positive findings and minimize associated harms. Patients and physicians require a neutral analysis to place pharmaceutical advertising into proper perspective. The Cochrane Collaboration does just that as an independent worldwide network not beholden to the drug industry.
On evaluating Risperdal, the Cochrane group concludes the evidence regarding Risperdal appears to be of very low quality with a probable bias in favor of the drug. As a result of the significant potential for harm, Risperdal and related drugs should be prescribed with extreme caution and not recommended prior to considering safer alternatives.
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