Risperidone

Also indexed as: Risperdal®

Risperidone is used to manage symptoms associated with psychotic disorders, especially schizophrenia.

Summary of Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)

Beneficial May be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Vitamin B6

Vitamin E
Check Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.

Licorice

White Peony
Depletion or interference

None known
Supportive interaction

None known
Reduced drug absorption/bioavailability

None known
Adverse interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Vitamin E and Vitamin B6
Vitamin E along with vitamin B6 was used to treat a side effect of risperidone called neuroleptic malignant syndrome in a 74-year-old woman, and results were encouraging.1 However, whether vitamin E and vitamin B6 supplementation might help prevent this condition in people taking risperidone is unknown.

Lithium
Lithium is a mineral present in large amounts in some medications, and may be included in some mineral supplements. The combination of lithium and risperidone has produced unwanted side effects such as delirium, confusion, and fever.2 3 Smaller amounts of lithium are available in some nutritional supplements, but it is not known whether these amounts are enough to cause a problem in individuals taking risperidone.

Interactions with Herbs

Licorice (Glycyrrhiza radix) and White peony (Paeoniae radix)
An Oriental herb formula containing Glycyrrhiza radix (licorice root) and Paeoniae radix (white peony root) successfully restored menses in a 28-year-old woman who had developed amenorrhea (lack of menstruation) while taking risperidone.4 Discontinuation of these herbs while the woman continued taking risperidone again led to disruption of her menses. Controlled research is needed to determine whether supplementation with licorice and peony might help prevent amenorrhea in women taking risperidone.

Interactions with Foods and Other Compounds

Food
Risperidone oral solution should be mixed in half a glass of water, coffee, orange juice, or low-fat milk and immediately consumed.5 It should not be mixed with cola or tea.6

Alcohol
Alcohol increases the breakdown of many antipsychotic drugs.7 More research is necessary to determine if alcohol consumption might lower blood levels of risperidone.

References

1. Dursun SM, Oluboka OJ, Devarajan S, Kutcher SP. High-dose vitamin E plus vitamin B6 treatment of risperidone-related neuroleptic malignant syndrome. J Psychopharmacol 1998;12:220–1.

2. Chen B, Cardasis W. Delirium induced by lithium and risperidone combination. Am J Psychiatry 1996;153:1233–4.

3. Swanson CL Jr., Price WA, McEvoy JP. Effects of concomitant risperidone and lithium treatment (letter). Am J Psychiatry 1995;152:1096.

4. Yamada K, Kanba S, Yagi G, Asai M. Herbal medicine (shakuyaku-kanzo-to) in the treatment of risperidone-induced amenorrhea. J Clin Psychopharmacol 1999;19:380–1.

5. Threlkeld DS, ed. Central Nervous System Drugs, Antipsychotic Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1998, 267f–8.

6. Threlkeld DS, ed. Central Nervous System Drugs, Antipsychotic Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1998, 267f–8.

7. Ereshefsky L. Pharmacologic and pharmacokinetic considerations in choosing an antipsychotic. J Clin Psychiatry 1999;60 Suppl. 10:20–30.