risperidone (Uzedy)

General Information

Uzedy is a long-acting subcutaneous risperidone formulation used for schizophrenia maintenance with monthly or every-2-month dosing options.

Pharmacology mirrors risperidone/paliperidone-class D2/5-HT2A blockade: prolactin elevation and EPS can be limiting, and metabolic monitoring remains important.

Label describes a subcutaneous depot with two absorption peaks and steady state approached within ~2 months of initiation. The mean apparent half-life is ~14–22 days, reflecting prolonged release and absorption.

For depot comparisons and planning across antipsychotics, see the LAI Navigator and the compare tool.

Uzedy is often selected when a less frequent visit cadence (monthly or every 2 months) is desired and the clinic can reliably deliver on the scheduled injection plan. Practical constraints include injection-site reactions, prolactin/EPS monitoring, and slower dose "steerability" compared with oral therapy.

Mechanism of Action

Refer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.

Risperidone antagonizes dopamine D2 and serotonin 5-HT2A receptors with additional activity at α1-adrenergic and histamine H1 receptors.

D2 blockade supports antipsychotic effects but contributes to prolactin elevation and EPS risk, especially at higher doses.

• Antagonist at dopamine D2 and serotonin 5-HT2A receptors.
• Antagonist at α1-adrenergic and histamine H1 receptors (orthostasis/sedation).
• Minimal muscarinic receptor affinity.

Metabolism and Pharmacokinetics

• Risperidone is metabolized primarily via CYP2D6; interaction profiles matter when adding strong 2D6 inhibitors.
• Uzedy forms a subcutaneous depot and shows two absorption peaks. Label reports median tmax for the combined active moiety of ~8–14 days and therapeutic concentrations described within 6–24 hours after the first injection.
• Label reports a mean apparent half-life of ~14–22 days, reflecting prolonged release and absorption.

Dosing and Administration

• Establish oral tolerability before initiating depot therapy when feasible. Uzedy is administered as a subcutaneous injection with either monthly or every-2-month intervals depending on selected dose.
• Dose selection is label-based and typically guided by the established effective oral risperidone dose; verify conversion tables and missed-dose guidance in the product label.
• When using the every-2-month option, clinic reminders and a backup plan for missed visits become especially important because delayed injections can increase relapse risk before there is an opportunity to "correct" the dose day-to-day as with oral therapy.
• Because depot effects persist between visits, response assessment often spans multiple injection cycles, especially when changing doses or intervals.

Monitoring & Labs

• Weight/BMI and waist circumference; fasting lipids and glucose/HbA1c at baseline and periodically.
• Movement disorder monitoring (akathisia, parkinsonism, tardive dyskinesia), especially after initiation and dose adjustments.
• Prolactin-related symptom review (sexual dysfunction, menstrual changes, galactorrhea).
• Injection site assessment and documentation (site rotation, local reactions).

Adverse Effects

Interactions

• Strong CYP2D6 inhibitors (some SSRIs) can increase risperidone exposure and adverse effects; consider dose adjustment and closer monitoring.
• Enzyme inducers can lower exposure and increase relapse risk; depot dose adjustments are less "steerable" than with daily oral dosing.
• Additive CNS depression and orthostasis can occur with alcohol, benzodiazepines, opioids, and antihypertensives; monitor falls risk.

Other Useful Information

• Depot outcomes are strongly influenced by clinic workflow: reminders, reliable scheduling, and clear documentation of last injection date and site.
• Use the schizophrenia hub for relapse-prevention pathways and education links.

References

1. Uzedy (risperidone) Extended Release Injectable Suspension — Prescribing Information — 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)