Risperidone: a review

Area of Science:

• Psychiatry
• Pharmacology
• Neuroscience

Background:

• Clozapine, a second-generation antipsychotic, has risks like agranulocytosis, leading to restricted use.
• Development of novel second-generation antipsychotics (SGAs) like risperidone and olanzapine was stimulated by clozapine's limitations.
• These novel SGAs exhibit varied pharmacological profiles and mechanisms, offering potential advantages over classical neuroleptics.

Purpose of the Study:

• To review the clinical database for risperidone in schizophrenia treatment.
• To highlight risperidone's role as a novel second-generation antipsychotic.
• To discuss the pharmacological basis and clinical profile of risperidone.

Main Methods:

• Review of extensive clinical data on risperidone in schizophrenia.
• Analysis of risperidone's pharmacological profile as a combined 5-HT2A and D2 receptor antagonist.
• Comparison of risperidone's efficacy and tolerability with classical neuroleptics and other novel SGAs.

Main Results:

• Novel SGAs, including risperidone, demonstrate better extrapyramidal symptom tolerability than classical neuroleptics.
• These agents show a broader efficacy spectrum, addressing negative symptoms, depression, and cognitive deficits in schizophrenia.
• Risperidone, introduced in the 1990s, achieved global acceptance due to its clinical profile.

Conclusions:

• Risperidone is a significant novel second-generation antipsychotic with a well-established clinical database for schizophrenia.
• Its dual 5-HT2A and D2 receptor antagonism aligns with mechanisms thought to underlie clozapine's efficacy.
• Risperidone offers advantages in treating schizophrenia, including improved tolerability and broader symptom coverage.