Mania in bipolar disorder recommended initial dose – 2 mg per day in one portion. If necessary, this dose may be increased to 2 mg per day, no more than a day. For most patients, the optimal dose is 6.2 mg per day. Conduct disorders in patients with mental retardation patients weighing 50 kg or more – the recommended initial dose – 0.5 mg once daily. If necessary, this dose may be increased to 0.5 mg per day, no more than a day.
For most patients, the optimal dose is 1 mg per day. However, preferred for some patients receiving 0.5 mg per day, whereas some require increasing doses up to 1.5 mg per day. Patients weighing less than 50 kg – The recommended initial dose – 0.25 mg once daily. If necessary, this dose may be increased by 0.25 mg per day, no more than a day. For most patients, the optimal dose is 0.5 mg per day. However, for some patients receiving preferable to 0.25 mg per day, while others need to increase the dose to 0.75 mg per day. Use chlorodehydromethyltestosterone – bd 10 in adolescents should be carried out under the constant supervision of a doctor. Use in children under 15 years old Not recommended.
Side effect On the part of the nervous chlorodehydromethyltestosterone – bd 10 system: insomnia, agitation, anxiety, headache, sometimes – drowsiness, fatigue, dizziness, impaired concentration, blurred vision, rarely – extrapyramidal symptoms (tremor, rigidity, hypersalivation, bradykinesia, akathisia, acute dystonia) , mania or hypomania, stroke (in elderly patients with predisposing factors), as well as hypervolemia (either due to polydipsia or because the syndrome of inappropriate secretion of antidiuretic hormone), tardive dyskinesia (involuntary rhythmic movements mainly language and / or persons) neuroleptic malignant syndrome (hyperthermia, muscle rigidity, instability of the autonomous functions, impaired consciousness and increasing creatine phosphokinase levels), violation of thermoregulation and seizures. From the digestive system: constipation, dyspepsia, nausea or vomiting, abdominal pain, increased activity of “liver” transaminases , dry mouth, hypo- or hypersalivation, anorexia and / or increased appetite, increased or decreased body weight. on the part of the cardiovascular system: sometimes orthostatic hypotension, reflex tachycardia, or increased blood pressure.
From the side of hematopoiesis: neutropenia, thrombocytopenia. From endocrine system: galactorrhea, gynecomastia, irregular menstruation, amenorrhea, weight gain, hyperglycemia and exacerbation of pre-existing diabetes. With the genitourinary system: priapism, erectile dysfunction, ejaculation disorder, anorgasmia, urinary incontinence. Allergic reactions: rhinitis, rash, angioedema, photosensitivity. For the skin: dry skin, hyperpigmentation, itching, seborrhea. Other: arthralgia.
Symptoms: drowsiness, sedation, depression of consciousness, tachycardia, hypotension, extrapyramidal disorder, in rare cases, lengthening the interval chlorodehydromethyltestosterone – bd 10 it is necessary to ensure a free airway to ensure adequate oxygenation and ventilation, gastric lavage (after intubation if the patient is not consciousness), and the appointment of activated charcoal in combination with laxatives.Symptomatic therapy directed at maintaining vital functions of the body.
The interaction with other drugs
Given risperidone has effect primarily on the central nervous system, it should be used with caution in combination with other drugs central action and alcohol.
Clozapine reduces risperidone clearance .
When using carbamazepine marked reduction in the concentration of the active antipsychotic fraction of risperidone in plasma. Similar effects may occur with other hepatic enzyme inducers.
Phenothiazines, tricyclic antidepressants and some β adrenoblokatory may increase plasma concentrations of risperidone, but this does not affect the concentration of the active antipsychotic fraction.
Fluoxetine can increase plasma concentrations of risperidone, but less concentration active antipsychotic fraction, so the dose of risperidone should be adjusted.
in the application of risperidone with other drugs that are highly bound to plasma proteins, clinically pronounced displacement of a drug from the plasma protein fraction is observed.
Antihypertensive medicines increase the severity of blood pressure reduction on the background risperidone.
Cautions transition from other antipsychotic therapy. In schizophrenia, chlorodehydromethyltestosterone – bd 10 the beginning of treatment with risperidone, we recommend gradually cancel the previous therapy, if clinically justified. If patients are transferred from the depot forms of therapy antipsychotics, risperidone it is recommended to start in place of the next scheduled injection. Periodically assess the need for continued therapy potivoparkinsonicheskimi drugs. In connection with the a-adrenoceptor blocking effect of risperidone, orthostatic hypotension can occur, especially during the initial dose adjustment. In the event of hypotension should consider lowering the dose. In patients with diseases of the cardiovascular system, as well as dehydration, hypovolemia, or cerebrovascular disorders, the dose should be increased gradually, as recommended (see. Dosage and administration).
The occurrence of extrapyramidal symptoms chlorodehydromethyltestosterone – bd 10 is a risk factor for the development of tardive dyskinesia. In case of signs and symptoms of tardive dyskinesia should consider abolishing all antipsychotics. In the event of a neuroleptic malignant syndrome, characterized by hyperthermia, muscle rigidity, instability of the autonomous functions, impaired consciousness and increased levels of creatine is necessary to cancel all antipsychotic drugs, including risperidone. In case of cancellation of carbamazepine and other inducers of “liver” enzymes risperidone dose should be reduced. Should Patients recommend to refrain from eating because of the possibility of weight gain. During the treatment should refrain from activities potentially hazardous activities that require high concentration and psychomotor speed reactions, as well as the reception of alcohol.