Optimal dosing with risperidone: updated recommendations

J Clin Psychiatry. 2001 Apr;62(4):282-9. doi: 10.4088/jcp.v62n0411.


Background: Drug dosages utilized during controlled clinical trials are not always optimal for patients encountered in day-to-day practice. The original trials of risperidone, a novel antipsychotic, suggested that an initial target dose of 6 mg/day was appropriate, but these trials were necessarily conducted among patients who were chronically impaired, hospitalized, and often partly drug resistant.

Data sources: Relevant data relating to the dosage of risperidone identified through an online (MEDLINE) search using the keywords risperidone, schizophrenia, schizoaffective disorder dementia, bipolar disorder, and dose were supplemented by a review of international and U.S. Congress abstracts in which the dose of risperidone was specifically described.

Conclusion: On the basis of naturalistic studies, clinical audit, phase 4 trials, positron emission tomography data, and 5 years of clinical experience, the currently recommended target dose of risperidone is 4 mg/day for most patients, with less-rapid titration than previously recommended. Moreover, a lower dose than this and slower titration may be appropriate for elderly patients, young patients, and first-episode patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / drug therapy
  • Clinical Trials as Topic
  • Dementia / drug therapy
  • Drug Administration Schedule
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Meta-Analysis as Topic
  • Middle Aged
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Psychotic Disorders / drug therapy*
  • Risperidone / administration & dosage*
  • Risperidone / therapeutic use
  • Schizophrenia / drug therapy
  • Tomography, Emission-Computed / statistics & numerical data


  • Antipsychotic Agents
  • Risperidone