Essay on Risperidone as Antipsychotic Treatment for Acute Mania

General Description

Risperidone retails as the Risperdal brand or under the generic name risperidone. It is primarily an approved antipsychotic treatment for acute mania, schizophrenia, and bipolar disorder. It enhances against schizophrenia symptoms like delusions, hallucinations, and disorganized thinking (Advokat, Comaty, & Julien, 2014). In some patients, it leads to better outcomes against decreased speech productivity, social isolation, and motivation. For people suffering mania, it improves against racing thoughts, elevated mods, inflated self-esteem, irritability, impulsivity, and reduced need for sleep. It is a medication also approved for treating adolescents as well as children aged between 5 and 16 years diagnosed with irritability stemming from autistic disorders (Advokat et al., 2014). It enables autistic patients show less aggressions towards peers, temper tantrums, self-injurious tendencies and rapidly altering moods. Risperidone is not approved by the FDA for alternative uses though it is generally used by physicians in enabling older people experiencing memory loss or persons with developmental disabilities counter behavioral problems like agitation (Rolland, Jardri, Amad, Thoas, Cottencin, & Bordet, 2014). It is similarly applied to arrest behavioral challenges among children suffering depression, bipolar disorder, schizophrenia and other mental illnesses. Risperidone is also prescribed in the long term management of Tourette’s disorder.

Mechanism of Action

The mechanism of action of this particular drug is largely unknown. As a second generation antipsychotic medication, it exhibits affinity for alpha 2, Alpha 1, H1 receptors, 5-HT2A, and D2 (Advokat et al., 2014). Present theories provide that it bears capacities to block the 5-HT2A and D2 receptors. The ability to cutoff action of the dopaminergic D2 receptors within the limbic system decreases positive schizophrenia symptoms like delusions, erratic speech and behavior as well as hallucinations (Rolland et al., 2014). Obstruction of 5-HT2A receptors within the mesocortical tract results in dopamine excesses and greater dopamine transmissions leading to exclusion of the negative symptoms among patients. It also attaches to alpha 1 adrenergic receptors as well as lesser binding action at the alpha 2 and histamine adrenergic receptors.

Dosage, Administration, Absorption, and Metabolism

Risperidone is administered as standard 0.25, 0.5, 1, 2, 3, 4, and 6mg tablets. It is highly discouraged for patients to halve the tablets as it may compromise desired dosage regimen (Advokat et al., 2014). When a patient is tapering down the use of another antipsychotic treatment, it is recommended that Risperidone be administered in the following scheduled treatment. For schizophrenic adults, it is recommended that the treatment be accorded once or two times daily with patients begin dosage with 2mg per day (Advokat et al., 2014). Dosage can thereafter be increased to 4mg on day two. In accordance with physician advice, dosage may be increased or remain the same. Dosages exceeding 10mg daily have not been supported as being more effective.

Elderly patients tolerate the drug well with dosage recommended at 0.5mg two times daily at the start and then adjusted incrementally to between 1 and 2mg twice each day. There is little information on its action among children below 15 years (Macluluch, Anand, Davis, Jackson, Barugh, Hall, Ferguson, …& Cunningham, 2013). For children suffering bipolar mania, administration is recommended at a schedule of once daily beginning with 2mg. adjustments are to be accorded intervals of 24 hours with increments in dosage of 1mg. for bipolar mania symptoms, Risperidone is recommended at doses of 2 and 6mg daily. However, physicians are advised to ensure that use of the medication is justified and continually evaluated. For dementia patients, a dosage of 0.25mg twice daily is recommended at the beginning and increased accordingly until the target dosage is attained. For autistic individuals, it is to be administered relative to body weight. Active metabolites breakdown Risperidone depending on whether the drug is administered through oral formulation which has a half-life of between 20 and 24 hours while long acting drug breakdown in between 3 and 6 days (Advokat et al., 2014). For long acting Risperidone, the elimination phase takes about 7and 8 weeks since the last administration.

Side Effects and Contraindications

This particular drug presents relatively minor side effects occurring at dosages of 6 mgs and less. Some patients tend to experience lower blood pressure, dizziness, sleepiness, heart palpitations, weight gain, constipation, fatigue and sexual dysfunction (Advokat et al., 2014). Other side effects include diabetes, weight gain, high cholesterol, females loosing menstruation and males becoming sexually dysfunctional. This medication is contraindicated for patients suffering hypersensitivity as a result of its use.

Overdose

Post marketing as well as premarketing experiences with this medication indicates that the outcome of large doses only results in exaggerated manifestation of its pharmacological effects (Advokat et al., 2014). These include hypotension and tachycardia, drowsiness and sedation, convulsion and extrapyramidal symptoms.

Other Notes

There is still little research investigation as to how the drug interacts with other forms of drugs. However, based on its influence on the central nervous system, it is advisable to ensure much care when using similar medication and alcohol (Rolland et al., 2014). Among people using Risperidone to curb bipolar mania, it was found that suicide attempts are related to discontinuation of the drug.

Concluding Remarks

Risperidone as a second generation antipsychotic works by curbing the activities of serotonin and dopamine. It mainly arrests symptoms among patients suffering schizophrenia, autism, bipolar mania, dementia and other mental conditions. However, iot may take apto six weeks for the full advantages of the drug in a patient though improvements in symptoms are generally noticeable in a few weeks. It is a relatively low risk medication for patients with no serious incidences of reported death due to overdose or contraindications.

References

Advokat, C. D., Comaty, J. E., & Julien, R. M. (2014). Julien’s primer of drug action: A comprehensive guide to the actions, uses, and side effects of psychoactive drugs (13th ed.). New York, NY: Worth Publishers.

Macluluch, A. M. J., Anand, A., Davis, D. H. J., Jackson, T., Barugh, A. J., Hall, R. J., Ferguson, K. J., …Cunningham, C. (2013). New horizons in the pathogenesis, assessment and management of delirium. Age and Aging, 42(6), 667-674. doi: 10.1093/ageing/aft148

Rolland, B., Jardri, R., Amad, A., Thoas, P., Cottencin, O., & Bordet, R. (2014). Pharmacology of hallucinations: Several mechanisms for one single symptom?  BioMed Research International, 2014, 1-9. doi: 10.1155/2014/307106