Risperdal (Risperidone)
Risperdal (Risperidone): pharmacological and clinical features
Risperdal (Risperidone) – it is a selective monoaminergic antipsychotic with a unique mechanism of action. The basis of his actions, like other atypicals, is already mentioned the central serotonin-dopamine antagonism.
Risperdal (Risperidone): has a marked affinity for serotonin 5-NT2A, and to dopamine D2-receptors. This affinity to the serotonin receptor is more pronounced than for dopamine. For the typical selectivity of risperidone effects on dopamine receptors risperdal and high prolactin levels located in the mesolimbic and Mesocortical tract, dysfunction of which bind the emergence of psychotic symptoms.
In therapeutic doses it has virtually no effect risperdal levels and hypothalamic-pituitary dopaminergic system responsible for the formation of unwanted side effects of traditional neuroleptics, particularly extrapyramidal can risperdal cause permanent sexual dysfunction and neuroendocrine. Risperdal blockade of dopamine receptors in the mesolimbic tract accounts for its main antipsychotic effect, which is risperdal and breasts sufficient to achieve 40-60% blockade of these receptors [12, 32]. Higher degree of blockade does not increase the effectiveness of neuroleptics, and leads to undesirable side effects. Impact of risperidone on 5-NT2A receptors provides a compensatory increase in the concentration of dopamine in system that minimizes the risk of extrapyramidal symptoms. In addition, the influence of risperidone on the mentioned serotonin receptors, localized mainly in the cerebral cortex, is provided by the reduction of deficits symptoms abilify risperdal together characteristic of schizophrenic process.
Risperidone also binds with alpha-1-adrenoceptors and, to a lesser extent, with the H1-histamine and alpha-2-adrenoceptors. Low affinity can risperdal cause a decrease in blood platelets, for H1-histamine receptors due to the weak intensity of sedation medication. Thanks to this especially in the pharmacotherapy risperidone do not develop complications such as bulimia and increased body weight.
It should be noted that risperdal consta review risperidone has no affinity for cholinergic receptors, and therefore if it is applied is not characterized by the appearance as the peripheral (blurred vision, dry mouth, constipation, urinary retention and ejaculation) and central (cognitive disorders), anticholinergic effects.
The peculiar spectrum of pharmacological actions of risperdal and children risperidone on the receptor structure of the central nervous system risperdal and children can distinguish two fundamental aspects that differentiate this drug.
• Integrated, multi-stakeholder normalizing effect on neuromediator imbalance in the brain that occurs in schizophrenia and the maximum thrust pathogenetic identified clinical and pharmacological effects.
Selective action on certain seroquel vs risperdal for kids subtypes of dopamine and serotonin receptors in specific brain areas that identify a high degree of safety of the drug.
Numerous clinical studies of Risperdal have identified the main features of its clinical action.
Risperidone is characterized by high efficiency side effects of risperdal when it is applied in all three main stages of schizophrenia:
- Cropped therapy;
- Stabilizing treatment;
- Antirecurrent therapy.
The greatest efficiency of risperidone occurs in paroxysmal forms of schizophrenia with a predominance of hallucinatory-delusional and affective-delusional symptomatology. This shows the ability of risperidone undifferentiated and uniformly effects of using risperdal doses reduce the various manifestations of psychosis. First, it affects the acute psychotic symptoms, provided sensual delirium, tension, emotion of fear, anxiety, and confusion. The effect of Risperdal manifested cbs report on risperdal during the first week of therapy. With the overall effect of antipsychotic drugs bind its ability to prevent progression of the disease risperdal side effects kids. In addition, the antipsychotic risperidone has a selective effect on the hallucinatory and delusional symptoms. These properties of Risperdal appear after the general antipsychotic action. It should be noted that from all available at this time arsenal neuroleptics effect is most pronounced in risperidone.
It is important to emphasize that Risperdal has demonstrated its effectiveness and treatment of subacute and chronic hallucinatory-paranoid states in paroxysmal-progression and nepreryvnotekuschey forms of risperdal side effects kids schizophrenia. It should be noted that just when this kind of state of classical neuroleptics are not effective enough. Against the background of risperidone therapy is rarely observed phenomenon of nonspecific sedation, confusion and characteristic of the classical therapy drugs. As one of the main advantages of subacute should be made clear effect, which manifests itself as regards the primary, the actual deficits, negative natural substitute for risperdal symptoms, as well as for secondary negative manifestations caused by psychotic disorders, phenomena associated with previous techniques of classical neuroleptics, as well as manifestations of depression and psychological reactions of patients to the disease.
For relief of hallucinatory-delusional disorders risperdal fda for kids in most cases requires the use of the drug in a dose of 6.8 mg / day maintenance dose depends on the severity of psychopathological manifestations, indicating the severity of the status and progression of the disease. It is when the paroxysmal form of pathology maintenance dose of risperidone gradually reduces to 4 mg / day. If paroxysmal-progression and continuous current conditions, including in the hallucinatory form of paranoid schizophrenia, the maintenance lamictal effexor risperdal pregnancy dose should remain relatively high – 5.6 mg / day.
Express the overall effect of antipsychotic risperidone can use the drug when arresting hypomanic, manic and manic-delusional risperdal use in children state, marked as in manic-depressive and schizoaffective psychosis, and in paroxysmal forms of schizophrenia consta risperdal. This distinct effect is observed in the first days. Simultaneously with the weakening of manic excitement disappear ideas of grandeur, sensuous manifestations of acute delirium and occur in some cases at the peak of disorder.
For the treatment of patients with risperdal 1mg image manic state, a relatively high dose of risperidone is required 6-8 mg / day. It is in these cases it is advisable accelerated increase in the daily dose. Reduced dosage should be done very slowly, purely individual. Average maintenance dose in these cases is 3-4 mg / day.
The effectiveness of risperidone in depressive-delusional states varies according to their variety. The highest efficiency observed in the presence of an acute sense of delirium with staged, verbal illusions, false recognition. The dose of Risperdal in these states information about risperdal should increase and reach 5-6 mg / day.
Risperidone is also used when arresting catatonic symptoms. It is known that such states is extremely difficult to treat by traditional antipsychotics and are often resistant to treatment. Successful implementation and the effectiveness of risperidone depend on the johnson johnson risperdal dose and duration of the drug, and severity of catatonic symptoms. Effect was much later risperdal and alzheimer’s than in the case of the affective-delusional and hallucinatory-paranoid state. With dominance in a fit of catatonic tenex and risperdal symptoms is an adequate dose of risperidone 4-8 mg / day, and the first signs of improvement emerge by the end of the third-fourth week of treatment. Risperdal has shown high therapeutic efficacy in clinical psychiatry border. This primarily refers to the obsessive-phobic, hypochondriacal senesto-and, to a lesser extent, depersonalizatsionnym states that have traditionally been considered within the creeping schizophrenia.
Risperidone has a high enough antiobsessivnoy activity. In therapy of phobic disorders, noted that the best effect is achieved in the treatment of social phobia and agoraphobia, in the least exposed to a reversal of the dominance of the clinical picture panfoby. In addition, the drug shows a high enough anxiolytic activity that allows you to cut short the alarm, which is one of the major pathogenetic mechanisms of obsessive-phobic disorders.
Within senesto-hypochondriacal disorders, a large proportion of affective symptoms risperdal effects, the presence in the structure of anxiety-depressive syndrome manifestations are predictors of good prognosis and a sufficient effect in treatment of risperidone. Marked hypochondriac symptoms are an indication for the use of risperidone in combination with antidepressants.
Risperidone also found application in the treatment of depersonalizatsionnyh disorders manifest violations of self-identity with a specific sense otchuzhdennnosti and diverse derealizatsionnyh phenomena. The best response to therapy noted in the case of the prevalence somatopsihicheskoy depersonalization. When ocd risperdal dominance in the structure of anxiety syndrome show the additional appointment of anxiolytics. Of particular note is the high efficiency of Risperdal (risperidone) in old age psychiatry, where the problem is a combination effects of risperdal injections forced on you of efficiency and safety is crucial. In this age group, side effects of antipsychotic therapy occur much more frequently, and transferred more difficult than in young and middle age, and often irreversible. This primarily refers to extrapyramidal symptoms, central and peripheral anticholinergic effects, as well as to such complications as sudden cognitive impairment or the state of confusion.
Risperidone is widely used in the treatment of schizophrenic psychoses aged and old, as well as the drug of choice for treatment of psychotic and behavioral symptoms in patients with Alzheimer’s disease, vascular and mixed forms of dementia. The recommended starting dose in these cases should be 0.5 mg / day, which is appointed by no less than 2 days. Further increase in dose should be individualized, with a gradual half life of risperdal increase of not more than 0.5 mg per day. The optimal dose is 1-2 mg / day. Finally, it deserves special attention as the use of risperidone long antirecurrent drug therapy. It was found comparable to conventional neuroleptics antirecurrent activity of risperidone, which, combined with favorable safety characteristics and the influence of negative symptoms would allow its use to prevent risperdal 1mg photo relapse and maintain the stability of remission restarting risperdal consta. In particular, it found that the risk of exacerbations on a background therapy of risperidone antirecurrent 1,5-2 times lower than in the case of classical risperdal /children antipsychotics. Thus risperidone does not cause side effects typical of the latter, and at long-term therapy helps to restore some cognitive functions, regarded pdd and risperdal as a clinical manifestation of schizophrenic process buy risperdal online. Against the background of prolonged treatment with risperidone in most cases eliminates the need for proof-readers for the relief of extrapyramidal symptoms, i.e., reduced risk of development of central and peripheral cholinolytic side effects. The above-mentioned therapy can not only minimize the risk of recurrence of the disease dementia risperdal, but also provides the so-called «mature» remission, which is reflected in the gradual reduction of both positive and negative symptoms.
As mentioned, risperidone has a favorable safety profile. Side effects associated with its use are relatively rare and less pronounced than in the classical and some atypical neuroleptics. Risperidone is practically not inherent to such serious depression medication mirtazapine risperdal sam-e seratonin complications of therapy traditional drugs, as neuroleptic malignant syndrome, tardive dyskinesia, cardiotoxicity. In terms of risk of akathisia risperidone is more secure than olanzapine. The risk of extrapyramidal adverse events (tremor, bradykinesia) increases with increasing dose and becomes clinically significant only at doses above 8 mg / day. They arise, usually at the beginning of treatment to achieve therapeutic doses and successfully stopped therapy. Against the background of prolonged treatment with risperidone, the need for supplemental proofreaders in most cases disappears.
Also very small possibility of development of anticholinergic side effects is possible. In this respect, risperidone is safer not only has the classical drugged, but atypical antipsychotics such as clozapine.
It is unlikely in the treatment of risperidone and neurometabolic disturbances (weight gain, hyperlipidemia), often imposing a serious clinical problem risperdal and mercury poisoning and chemical toxcity in the application of clozapine and olanzapine. The most common side effects of risperidone include insomnia, anxiety, and headache. Sleep disturbances usually develop in the early days of medication and do not depend on the time of admission. To their cupping what is risperdal is recommended to appoint additional agents to the hypnotic effects, including neuroleptic with sedative effect. Against the background of risperidone therapy may be observed risperdal and lamictal hyperprolactinaemia. In men, a complication seen decrease in libido, gynecomastia, in women – anorgasmia, galactorrhea, menstrual irregularities. These complications are functional, reversible, and are also dose-related. When expressed manifestations of hyperprolactinemia recommended the appointment of dopamine receptor agonists. Very rarely on the background therapy of risperidone, orthostatic hypotension occurs, which usually does not pose a serious clinical problem.
Thus, risperidone is highly effective and safe atypical antipsychotics. As the clinical benefits of the drug include the following:
• width of the therapeutic spectrum of what is risperdal used for action (effects on the positive and negative symptoms);
• beneficial effects on cognitive function and affective manifestations;
• rapidity of onset of effect;
• effectiveness at all stages of treatment of schizophrenia;
• high level of security;
• optimal compliance in the treatment process.
Of the drugs risperidone presented at the risperdal children pharmaceutical market, it should be emphasized by Risset Company «Pliva». Manufactured in full accordance with risperdal side effects European standards of quality, Risset is the most affordable in the economic sense among all the drugs risperidone, used in domestic clinical risperdal and schizophrenia practice. The latter factor often plays a decisive role in the selection of an atypical antipsychotic, particularly in conditions of prolonged antirecurrent therapy, and in this respect deserves priority attention Risset. Overall, the experience of Risperdal risperidone in the national mental health confirms the high potential and promising prospects in a variety of clinical situations. Further expansion of the scope of risperidone (Risseta) can optimize the strategy risperdal consta and tactics of treatment of major forms of mental pathology in accordance with modern international standards.
