Risperdal Consta (Risperidone) for Depression

Risperdal Consta (risperidone) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to help maintain treatment in adults with bipolar 1 disorder. It can be used alone or with other medicines like lithium or valproate.

How Risperdal Consta Works and How It’s Taken

Risperdal Consta is a type of medication called an antipsychotic. It works by affecting brain chemicals called dopamine and serotonin. In bipolar 1 disorder, this may help stabilize mood by reducing changes in brain signaling linked to mood episodes.

The exact way it works is not fully known.

Doctors prescribe Risperdal Consta for long-term treatment of bipolar 1 disorder. It can be used alone or with medicines like lithium or valproate to help prevent mood episodes. By targeting this pathway, the medication may help manage symptoms.

Risperdal Consta is given as an injection into a muscle every two weeks. A healthcare provider gives the shot in the upper arm or buttock.

Typical Dosing for Bipolar 1 Disorder

The recommended dose of Risperdal Consta for bipolar 1 disorder is 25 milligrams given every two weeks. It can be used alone (monotherapy) or with other medicines (adjunctive therapy), such as lithium or valproate.

For some people, doctors may increase the dose to 37.5 milligrams or 50 milligrams.

An oral form of risperidone, or another antipsychotic, is given with the first injection and continued for three weeks to make sure the medicine reaches the right level in the body.

Dose increases should not happen more often than every four weeks. It may take about three weeks to see the effect of a higher dose.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Risperdal Consta Side Effects

In clinical studies of Risperdal Consta for the maintenance treatment of bipolar 1 disorder in adults, the most common side effects occurred in about 5 percent to 24 percent of individuals. These side effects varied depending on whether Risperdal Consta was used alone or with lithium or valproate. These were:

Weight gain
Tremor (shaking)
Parkinsonism (movement symptoms such as stiffness, slowness, or shaking)

Serious Side Effects and Warnings

Risperdal Consta can cause serious side effects that require immediate medical attention. These include:

Increased risk of death in older adults with dementia-related psychosis — This medicine is not approved for dementia-related psychosis.
Stroke and transient ischemic attack (TIA) — These “mini-strokes” can occur in older adults with dementia-related psychosis.
Neuroleptic malignant syndrome (NMS) — This rare, life-threatening reaction can cause high fever, severe muscle stiffness, confusion, and unstable blood pressure or heart rate.
Tardive dyskinesia — Uncontrolled, repeated movements may not go away.
Metabolic changes — These can include high blood sugar, diabetes-related complications, higher cholesterol or triglycerides, and weight gain.
High prolactin levels — These hormone changes can cause missed periods, breast milk production, breast swelling, sexual side effects, or possible bone loss over time.
Orthostatic hypotension and fainting — A sudden drop in blood pressure when standing can cause dizziness or passing out.
Falls — These may happen due to sleepiness, dizziness, or movement problems.
Low white blood cell counts, including neutropenia and agranulocytosis — These can raise the risk of serious infections.
Cognitive and motor impairment — Problems with judgment and movement can affect activities such as driving a car.
Seizures — These can occur.
Dysphagia and aspiration — Trouble swallowing or food or liquid going into the lungs can lead to pneumonia.
Priapism — A painful erection that lasts a long time is a medical emergency.
Problems with body temperature regulation — These can include overheating or getting too cold.
Severe allergic reactions — These can include anaphylaxis or angioedema, which can cause swelling of the face, lips, tongue, or throat, and trouble breathing.

Get medical help right away if you think you are having a serious reaction.

How To Save on Risperdal Consta

Janssen Pharmaceuticals, the manufacturer of Risperdal Consta, offers the J&J withMe Savings Program. Eligible individuals with commercial insurance may pay as little as $10 per dose.

The J&J withMe Savings Program also provides support with understanding insurance coverage, including reviewing benefits and explaining coverage details. It offers tools and resources to help you get started with treatment, connect with others in the community, and access ongoing support.

To learn more, visit the J&J withMe Savings Program or call 866-562-6177.

What To Know Before Taking Risperdal Consta

Before starting Risperdal Consta, tell your doctor if you have never taken oral Risperdal. Your doctor should first make sure you can tolerate oral risperidone.

Tell your doctor if you have any allergies to risperidone, paliperidone, or any ingredients in Risperdal Consta. Do not take this medicine if you have had a serious allergic reaction to risperidone, paliperidone, or any of its ingredients.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Your doctor may check your blood sugar, cholesterol, triglycerides, weight, blood pressure, or blood cell counts before and during treatment.

Risperdal Consta is also FDA approved to treat schizophrenia in adults.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Risperdal Consta, talk with your doctor about the risks and benefits.

There is a pregnancy registry for individuals who take Risperdal Consta during pregnancy. To learn more, visit the National Pregnancy Registry for Atypical Antipsychotics or call 866-961-2388.

If you breastfeed while taking Risperdal Consta, watch your baby for too much sleepiness, poor weight gain, jitteriness, tremors, or abnormal muscle movements.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Risperdal Consta?
In studies of maintenance treatment for adults with bipolar 1 disorder, Risperdal Consta helped delay relapse compared with placebo (an inactive treatment). In one study, people who stayed on Risperdal Consta alone had a longer time before relapse than those who switched to placebo. Most relapses were manic symptoms.

In another study, people took Risperdal Consta with their usual treatment, mainly lithium or valproate. Relapse also was delayed in individuals who received Risperdal Consta.

How long does Risperdal Consta take to work for bipolar 1 disorder?
Risperdal Consta does not start working right away. After the first injection, only a small amount of medicine is released at first. The main release of the medicine begins about three weeks after the injection, continues for several weeks, and then slowly decreases.

Because of this delay, people should take an oral antipsychotic with the first injection and continue it for three weeks to keep enough medicine in the body.

What tests or monitoring are needed with Risperdal Consta for bipolar 1 disorder?
Individuals taking Risperdal Consta should have their blood sugar, cholesterol, and weight checked. If you have diabetes or are at risk, your doctor should check your blood sugar before and during treatment. If you have had low white blood cell counts, your doctor should check your blood counts during the first few months.

Your doctor may also check your blood pressure when standing. Tell your doctor if you have symptoms like increased thirst, frequent urination, weakness, or signs of infection such as fever.