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Risperidone Serum Levels in Depression: Insights From a Retrospective Therapeutic Drug Monitoring Study
Melike Kucukkarapinar1, Kohler Meike1,2, Weber Heike1
1Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg.
Therapeutic Drug Monitoring
|July 9, 2026
Summary
Therapeutic drug monitoring for risperidone in depression requires different reference ranges than those for schizophrenia. A preliminary range of 10-30 ng/mL is suggested for effective treatment of depressive disorders.
Area of Science:
- Pharmacology
- Psychiatry
- Clinical Chemistry
Background:
- Risperidone is an adjunctive treatment for treatment-resistant depression.
- Current therapeutic drug monitoring guidelines lack established risperidone reference ranges for depressive disorders.
Purpose of the Study:
- To compare risperidone active moiety (AM) serum concentrations between schizophrenia spectrum disorders (SSD) and depression patients.
- To establish preliminary therapeutic reference ranges for risperidone in depression.
Main Methods:
- Retrospective observational study of 401 inpatients administered risperidone (2015-2020).
- Comparison of AM serum concentrations (risperidone + 9-hydroxyrisperidone) between SSD and depression cohorts.
- Assessment of AM serum levels and treatment efficacy using the Clinical Global Impression-Improvement scale in the depression cohort.
Main Results:
- AM serum concentration was significantly higher in patients with SSD compared to those with depression (P < 0.001).
- 50% of depression patients achieved successful treatment with lower AM serum concentrations than typically used for SSD.
Conclusions:
- Established therapeutic reference ranges for SSD are not applicable to depression treatment.
- A preliminary therapeutic reference range of 10-30 ng/mL is suggested for risperidone in depressive disorders.
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