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Risperidone

Also indexed as: Risperdal®

Risperidone is used to manage symptoms associated with psychotic disorders, especially schizophrenia.

Interactions with Dietary Supplements

Vitamin E and Vitamin B6
Vitamin E along with vitamin B6 was used to treat a side effect of risperidone called neuroleptic malignant syndrome in a 74-year-old woman, and results were encouraging.1 However, whether vitamin E and vitamin B6 supplementation might help prevent this condition in people taking risperidone is unknown.

Lithium
Lithium is a mineral present in large amounts in some medications, and may be included in some mineral supplements. The combination of lithium and risperidone has produced unwanted side effects such as delirium, confusion, and fever.2 3 Smaller amounts of lithium are available in some nutritional supplements, but it is not known whether these amounts are enough to cause a problem in individuals taking risperidone.

Interactions with Herbs

Licorice (Glycyrrhiza radix) and White peony (Paeoniae radix)
An Oriental herb formula containing Glycyrrhiza radix (licorice root) and Paeoniae radix (white peony root) successfully restored menses in a 28-year-old woman who had developed amenorrhea (lack of menstruation) while taking risperidone.4 Discontinuation of these herbs while the woman continued taking risperidone again led to disruption of her menses. Controlled research is needed to determine whether supplementation with licorice and peony might help prevent amenorrhea in women taking risperidone.

Interactions with Foods and Other Compounds

Food
Risperidone oral solution should be mixed in half a glass of water, coffee, orange juice, or low-fat milk and immediately consumed.5 It should not be mixed with cola or tea.6

Alcohol
Alcohol increases the breakdown of many antipsychotic drugs.7 More research is necessary to determine if alcohol consumption might lower blood levels of risperidone.

Summary of Interactions for Risperidone

Depletion or interference None known
Adverse interaction None known
Side effect reduction/prevention Vitamin B6
Vitamin E
Supportive interaction None known
Reduced drug absorption/bioavailability None known
Other (see text) Licorice
White Peony

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Dursun SM, Oluboka OJ, Devarajan S, Kutcher SP. High-dose vitamin E plus vitamin B6 treatment of risperidone-related neuroleptic malignant syndrome. J Psychopharmacol 1998;12:220–1.

2. Chen B, Cardasis W. Delirium induced by lithium and risperidone combination. Am J Psychiatry 1996;153:1233–4.

3. Swanson CL Jr., Price WA, McEvoy JP. Effects of concomitant risperidone and lithium treatment (letter). Am J Psychiatry 1995;152:1096.

4. Yamada K, Kanba S, Yagi G, Asai M. Herbal medicine (shakuyaku-kanzo-to) in the treatment of risperidone-induced amenorrhea. J Clin Psychopharmacol 1999;19:380–1.

5. Threlkeld DS, ed. Central Nervous System Drugs, Antipsychotic Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1998, 267f–8.

6. Threlkeld DS, ed. Central Nervous System Drugs, Antipsychotic Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1998, 267f–8.

7. Ereshefsky L. Pharmacologic and pharmacokinetic considerations in choosing an antipsychotic. J Clin Psychiatry 1999;60 Suppl. 10:20–30.