Use of Risperidone in Children With Autism, Bipolar Disease, or Schizophrenia

Marcia L. Buck, Pharm.D., FCCP

Pediatr Pharm. 2008;14(1) 

In This Article

Dosing Recommendations

Prior to initiating risperidone, behavioral symptoms, as well as growth (height, weight, and sexual maturation), heart rate and blood pressure, and activity level should be assessed to establish a baseline. In patients with risk factors for diabetes, a fasting blood glucose should be obtained, if possible. Patients and family members should be counseled about the benefits and risks of risperidone therapy and the signs and symptoms of serious adverse effects which require medical attention. Parents should be prepared for the potential increase in appetite produced by risperidone and have a plan for managing their child's food intake.

The recommended starting dose for risperidone in children with autism is 0.25 mg/day for children 15 to 19 kg and 0.5 mg/day for children ≥ 20 kg. Therapy is typically initiated as a single daily dose in the morning or evening. The dose may be increased by 0.25 to 0.5 mg at a minimum interval of every 2 weeks. The effective dose range provided by the manufacturer is 0.5 to 3 mg/day. In patients who develop somnolence with once-daily dosing, the dose may be divided and administered twice daily. Risperidone doses should be reduced in patients with underlying renal or hepatic disease.[2,3]

In children and adolescents with bipolar mania or schizophrenia, the recommended starting dose is 0.5 mg/day, with titration by 0.5 to 1 mg daily until symptom control and/or a target dose of 1 to 6 mg is achieved. In adults, the recommended dose for initiation of risperidone is 2 mg/day with daily titration in 1 to 2 mg increments. The effective dose range for adults is 1 to 6 mg for bipolar disease and 4 to 16 mg for schizophrenia.[2,3]

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