An evaluation of risperidone drug interactions.
Risperidone, an atypical antipsychotic drug, is widely used in the treatment of psychoses associated with schizophrenia, Alzheimer's disease, and other psychiatric disorders. Polypharmacology is a necessary condition for the optimal treatment of many patients with comorbid psychiatric and medical illness. One concern raised by the widespread use of multiple concurrent pharmacotherapies is the potential for drug-drug interactions to adversely affect patient outcome. Accordingly, the biomedical literature was reviewed for reports of drug interactions involving risperidone, and the clinical significance of each report was evaluated. Additionally, the potential for risperidone to participate in drug interactions was evaluated by considering the drug's pharmacokinetic properties. Controlled studies and case reports indicate that risperidone has a low potential for metabolic drug interactions. Drugs that inhibit cytochrome P450 (CYP) 2D6 or induce or inhibit CYP3A4 may alter risperidone plasma concentrations, but the clinical significance of such interactions seems to be minimal. Adherence to a few guidelines for the design of dosage regimens should limit the effect of drug-drug interactions on patient status and contribute to optimal pharmacotherapy with risperidone.
DeVane
C L
CL
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston 29425-0742, USA. devanel@musc.edu
Nemeroff
C B
CB
D000927:Anticonvulsants / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D001569:Benzodiazepines / Q000009:adverse effects; D001798:Blood Proteins / Q000378:metabolism; D002317:Cardiovascular Agents / Q000009:adverse effects; D018680:Cholinergic Antagonists / Q000009:adverse effects; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D005765:Gastrointestinal Agents / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000378:metabolism; D011485:Protein Binding; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001798:Blood Proteins; D002317:Cardiovascular Agents; D018680:Cholinergic Antagonists; D005765:Gastrointestinal Agents; D001569:Benzodiazepines; D003577:Cytochrome P-450 Enzyme System; D018967:Risperidone