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How Safe Is Risperidone for the Elderly?

Mary McMahon
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Updated: Mar 03, 2024
Views: 31,456
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Risperidone for the elderly can be accompanied by an increased risk of stroke if it is not used with care. This antipsychotic medication is sometimes recommended to treat agitation, hallucination, and other symptoms of distress associated with dementia in older adults. When this medication is used in low doses and for short periods of time, it can be appropriate. For chronic problems that do not resolve, other treatment modalities may need to be considered in lieu of risperidone for the elderly, because of the long-term risks involved with this medication.

The concern with risperidone and other antipsychotics in older adults is that their use has been linked with an increased incidence of stroke. Especially if the dose is high or prolonged, the chances of experiencing an adverse event that could lead to severe complications or death increases dramatically. In the case of someone who has dementia because of a stroke, risperidone can be contraindicated due to concerns about the risk of a repeat event. For these patients, antipsychotics in general may not be safe.

Before recommending risperidone for geriatrics, a medical provider may carefully evaluate the situation. This medication may be used in small doses in the early stages of dementia to help a patient stay calm and manage side effects. For short term use, it can be effective for stabilizing patients and making them feel more comfortable. In the long term, the risks of stroke can start to outweigh the benefits provided by the medication, and it may be necessary to take the patient off the drug.

This medication may not be approved in all locations for the treatment of psychosis in older adults, although it can be used off-label in some instances. Medical practitioners using risperidone for the elderly may monitor their patients closely for signs of side effects like cardiovascular problems. If issues start to develop, the patient can be taken off the medication. Alternatives including other medications along with therapy and counseling to address agitation and distress may be available.

Concerns about the use of medications like risperidone for the elderly periodically results in revised guidelines. Patients and family members who are not sure whether a medication is appropriate can ask for specific information from the practitioner who recommends it. Doctors should be able to provide information about why a medication is being prescribed, any available alternatives, and the risks and benefits, to allow the patient to make an informed choice.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon981631 — On Dec 13, 2014

My mother with advanced dementia has been on risperidal for a couple of years. I asked them to take her off of it they reduced the dosage in the assisted living but kept her on it. My Mom was having some behavior issues when she was first prescribed, but now she is just in "chemical restraints" with risperdal. She has her eyes closed most of the time, is totally lethargic and falls a lot which apparently is one of the side effects.

She is in such a diminished state now, I have asked they taper her off this drug completely and let her experience some alertness in the last bit of her life. I have heard that lawsuits are being launched against Johnson and Johnson for advising to use this drug on the elderly with dementia when it is only intended for those with schizophrenia. Big Pharma is the devil as are all the schmucks who sell their souls for kick-backs from big pharma for peddling their poison.

By anon326106 — On Mar 20, 2013

My mum was diagnosed with apparent behavior issues and within eight weeks of being in the nursing home, she was sedated, eyes glazed over, unable to communicate properly, falling asleep often and wanting to die. With my doctor's ongoing monitoring, we discontinued the drug, she stayed with me for six months and my mother returned to her usual chirpy self, with no behavior issues.

Three months ago, the nursing home changed doctors and started prescribing the medication again without advising me, and they were not going to allow her to visit me for more than five days. I rang the public advocate, they contacted the nursing home and advised they have no grounds for the time frame. My mother came to stay with me for more than a week and I was given the risperdal! I accidentally stumbled on some information that stated the medication can be stopped for no longer than five days, and I have a suspicion they were trying not to make me aware that she was back on it. I could tell though, because she was again depressed, had a sore stomach, high blood pressure, a blotch in her eye and was not herself, but extremely happy to be with my family.

I notified every department, and they were not very helpful as they would advise me to contact other departments. She began to deteriorate very quickly and had high blood pressure. I was trying to remove her from the nursing home, but the system is very complicated and money dependent and unfortunately she suffered a stroke two days ago. Although she is unable to function properly, they are still giving her risperidol? She is having trouble swallowing, feels heavy and is on antibiotics for an infection in the stomach – all the concerns I kept telling them about. Her speech is bad and she is a changed lady.

Now they are saying it has nothing to do with the medication, but I saw the transformation with my own eyes in my mother. The problem is these people keep telling me they are the professionals, but yet they are unable to acknowledge the obvious signs that were occurring. My mother is not going to make a full recovery and I am waiting to see what's coming.

I contacted the complaints department and said I want someone to independently go and check and test my mum's system and all I could get was they contacted the home today, and this may have prompted them to carry out their care properly and have transferred her to another hospital for tests. I have spoken with the audit body and the office of the commissioner to express my disgust with the system.

My mother went in fit and in good spirits And what has happened is they have removed her right to live a quality life. Oh and she got diabetes type 2 within the first eight weeks. I bet Jansen, Johnson and Johnson, whoever get the profits from my mothers diabetic medication are happy with their full pockets.

My mother was supposed to go into the home for quality of life and they would have her best interests in mind. Unfortunately, they failed on both counts.

By anon254906 — On Mar 15, 2012

The alternatives are terrible. To have no sanity at all is a fate worse than death. The ban for the elderly, those who can become less mentally ill and higher functioning on risperidone, should end. It's inhuman to condemn the elderly to insanity for the rest of their lives. To possibly die prematurely, but sane at 90 versus dying totally insane at 92? Please God, allow somebody in the medical profession to allow me to die sane at 90 and lock the jerk up who wants me to live insane at 92. He's a sick puppy.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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