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risperidone (Perseris)

Long-acting injectable antipsychoticLAI available

Brands: PERSERIS

Last reviewed 2025-12-30

Reviewed by PsychMed Editorial Team.

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Quick answers

  • What is risperidone (Perseris)?

    Perseris is a monthly subcutaneous long-acting risperidone formulation for schizophrenia maintenance. It is often considered when relapse risk is driven by inconsistent daily dosing and a scheduled monthly visit is more reliable than pills.

  • What is PERSERIS?

    PERSERIS is a brand name for risperidone (Perseris).

  • What is PERSERIS (risperidone (Perseris)) used for?

    Label indications include: Schizophrenia (maintenance treatment).

  • What drug class is PERSERIS (risperidone (Perseris))?

    Long-acting injectable antipsychotic.

  • What is the mechanism of action of PERSERIS (risperidone (Perseris))?

    Monthly subcutaneous long-acting risperidone depot (D2/5-HT2A antagonist) intended for schizophrenia maintenance when scheduled injection visits support adherence.

  • What strengths does PERSERIS (risperidone (Perseris)) come in?

    Subcutaneous long-acting depot injection, administered monthly (q4wk). Product-specific preparation and injection technique apply.

  • Is PERSERIS (risperidone (Perseris)) a controlled substance?

    No — it is not scheduled as a controlled substance under U.S. federal law.

  • How is risperidone (Perseris) started as a long-acting injectable (LAI)?

    Oral tolerability is typically established before switching to Perseris. Unlike risperidone microspheres (Consta), Perseris does not generally require a multi-week oral overlap after the first injection.

Snapshot

  • Class: Long-acting injectable antipsychotic
  • Common US brands: PERSERIS
  • Long-acting injectable formulation available.
  • Therapeutic drug monitoring not routinely recommended.
  • Last reviewed: 2025-12-30

Label indications

Schizophrenia (maintenance treatment).

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Clinical Highlights

Perseris is a monthly subcutaneous long-acting risperidone formulation for schizophrenia maintenance. It is often considered when relapse risk is driven by inconsistent daily dosing and a scheduled monthly visit is more reliable than pills. This page focuses on Perseris. For oral risperidone (broader labeled indications) and for other LAI options derived from risperidone or paliperidone, see the risperidone overview, the paliperidone overview, and the LAI Navigator.

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  • Pharmacology mirrors risperidone/paliperidone-class D2/5-HT2A blockade: prolactin elevation and EPS can be limiting, and metabolic monitoring remains important. Compared with many FGAs, weight gain risk is typically higher, but EPS risk is often lower than with high-potency FGAs.
  • Perseris has a distinct absorption profile with two peaks after each injection (early hours and again around 10–14 days). Label describes an apparent terminal half-life of ~9–11 days, driven largely by depot release.
  • The compare view can help compare depot options; the evidence feed tracks curated reading for this formulation.
  • Schizophrenia (adults): long-acting maintenance formulation.

Dosing & Formulations

Subcutaneous injection administered monthly. Perseris is supplied as a prefilled kit and requires product-specific preparation and injection technique (subcutaneous, not intramuscular). Dose selection is individualized and label-based. Perseris is available as two strengths (commonly 90 mg or 120 mg monthly) aligned to prior oral risperidone dosing; conversion tables should be verified in the product label.

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  • Oral tolerability is typically established before switching to Perseris. Unlike risperidone microspheres (Consta), Perseris does not generally require a multi-week oral overlap after the first injection.
  • Missed-dose handling should be documented at initiation; depot therapy can reduce daily adherence burden, but late injections can still lead to undertreatment.

Monitoring & Risks

Boxed warning: increased mortality in elderly patients with dementia-related psychosis (antipsychotic class warning). Prolactin elevation is common and can present as sexual dysfunction, menstrual changes, galactorrhea, or bone health concerns; monitoring is typically symptom-driven.

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  • EPS and akathisia can occur, especially at higher doses or with polypharmacy; routine movement-disorder screening is part of follow-up.
  • Metabolic monitoring remains standard (weight/BMI, lipids, glucose), as weight gain and cardiometabolic changes can occur over time.
  • Injection-site reactions are a practical constraint for subcutaneous depots; rotating sites and documenting injection location help support tolerability.

Drug Interactions

Risperidone is metabolized by CYP2D6. Strong 2D6 inhibitors (some SSRIs) can raise risperidone exposure and adverse effects; review interaction profiles when adding antidepressants. Strong enzyme inducers can lower exposure and increase relapse risk. Depot dose adjustments are less “steerable” than with daily oral dosing.

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  • Additive CNS depression and orthostasis can occur with sedatives, alcohol, or antihypertensives; clinical monitoring is individualized to baseline risk.

Practice Notes

Perseris is a workflow-dependent medication: staff need training on the kit preparation and subcutaneous injection technique, and teams benefit from a standardized injection log and missed-dose protocol. Because depot effects persist between visits, teams often reassess across multiple injection cycles before concluding a dose is too low or intolerable.

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  • A simple between-visit checklist (sleep, appetite/weight, restlessness, and sexual side effects) can help patients and caregivers describe changes that might otherwise be missed at a once-monthly follow-up.
  • Use the print handout for clinic workflows and the schizophrenia hub for relapse-prevention pathways.

Long-acting injectable (LAI) options

  • Risperidone (Perseris)
    Interval
    Monthly (q4wk)
    Oral overlap
    None after first injection (establish oral tolerability first)
    Injection site
    Subcutaneous (abdomen or back of arm)
    Notes
    • Neither a loading dose nor oral supplementation is recommended after initiation (verify in labeling)

References

  1. PERSERIS prescribing information (DailyMed, 2025). — DailyMed (2025)
  2. RISPERDAL (risperidone) prescribing information — DailyMed (2025)
  3. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia — American Psychiatric Association (2020)
  4. Comparative Efficacy AND Tolerability OF 15 Antipsychotic Drugs IN Schizophrenia: A Multiple Treatments Meta Analysis — The Lancet (2013)Meta-analysisschizophreniaefficacy
  5. AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology — Pharmacopsychiatry (2018)
Risperidone (Perseris) (PERSERIS) — Summary — PsychMed