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Brand: RISPERDAL CONSTA
Published 2025-12-23 · Last reviewed 2025-12-30 · 4 references
Content sourced from FDA labeling (DailyMed) and peer-reviewed literature.
Risperidone microspheres (Risperdal Consta) is a long-acting injectable formulation of risperidone dosed every 2 weeks.
It is used for schizophrenia maintenance and bipolar I maintenance (monotherapy or adjunct, per labeling), often when relapse risk is driven by inconsistent daily dosing.
A defining operational feature is the initial release lag: label initiation includes an oral overlap period (often ~3 weeks) to maintain coverage while sustained depot release begins.
Pharmacology mirrors risperidone/paliperidone-class D2/5-HT2A blockade: prolactin elevation and EPS are frequent clinical constraints, and metabolic monitoring remains important.
Risperidone microspheres is most often selected when teams want a long-established depot option and can support the operational complexity of overlap initiation and q2wk visits. The trade-offs are a higher prolactin signal and meaningful EPS risk in some patients, plus the need for an oral overlap during initiation and some missed-dose scenarios.
View labelExactRefer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.
Risperidone is a dopamine D2 and serotonin 5-HT2A antagonist with additional alpha-adrenergic and histaminergic activity.
Therapeutic effect is generally attributed to sustained D2 receptor occupancy with serotonergic modulation, while prolactin elevation and EPS reflect dopamine blockade in pituitary and nigrostriatal pathways.