【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於老年人 (除非用於思覺失調、雙極症、或化療止吐)。

思覺失調症、雙極症
Irritability autistic disorder; Bipolar I disorder; Schizophrenia

The mechanism by which risperiDONE exerts its antipsychotic effect is unknown. RisperiDONE is a selective monoaminergic antagonist with a strong affinity for serotonin Type 2 (5-HT2) receptors and a slightly weaker affinity for dopamine Type 2 (D2) receptors.

Absorption:
Bioavailability, oral: 70%.
Distribution:
1. Vd: 1.1 L/kg (1 to 2 L/kg)
2. Protein binding, adults: 90%
Metabolism:
Hepatic: extensively via CYP2D6 pathway
Elimination Half Life:
3 to 20 hours

Hypersensitivity to risperiDONE, paliperidone (an active metabolite of risperiDONE), or any component of the product.

C (FDA)

Infant risk cannot be ruled out.

Common:
1. Dermatologic: Rash
2. Endocrine metabolic: Hyperprolactinemia, weight increased
3. Gastrointestinal: Constipation. diarrhea, excessive salivation, increased appetite, indigestion, nausea, upper abdominal pain, vomiting, xerostomia
4. Neurologic: Akathisia, dizziness, dystonia, parkinsonism, sedated, tremor
5. Ophthalmic: Blurred vision
6. Psychiatric: Anxiety
7. Respiratory: Cough, nasal congestion, nasopharyngitis, pain in throat, upper respiratory infection
8. Other: Fatigue, pain
Serious:
1. Cardiovascular: Prolonged QT interval, sudden cardiac death, syncope
2. Endocrine metabolic: Diabetic ketoacidosis, hypothermia
3. Gastrointestinal: Pancreatitis
4. Hematologic: Agranulocytosis, leukopenia, neutropenia, thrombocytopenia, thrombotic thrombocytopenic purpura
5. Neurologic: Cerebrovascular accident, seizure, tardive dyskinesia
6. Reproductive: Priapism
7. Respiratory: Pulmonary embolism
8. Other: Neuroleptic malignant syndrome

Bipolar mania:
Initial 2 to 3 mg once daily; if needed, adjust dose by 1 mg daily in intervals ≥24 hours; dosing range: 1 to 6 mg daily.
Schizophrenia:
1. Initial: 2 mg daily in 1 to 2 divided doses; may be increased by 1 to 2 mg daily at intervals ≥24 hours to a recommended dosage range of 4 to 8 mg daily.
2. Maintenance: recommended dosage range 2 to 8 mg daily.
3. Daily dosages >6 mg do not appear to confer any additional benefit, and the incidence of extrapyramidal symptoms is higher than with lower doses.

Bipolar mania:
(Children and Adolescents 10 to 17 years)
1. Initial: 0.5 mg once daily; dose may be adjusted in increments of 0.5 to 1 mg daily at intervals ≥24 hours to a dose of 1 to 2.5 mg daily.
2. Doses ranging from 0.5 to 6 mg daily have been evaluated; however doses >2.5 mg daily do not confer additional benefit and are associated with increased adverse events. Patients experiencing persistent somnolence may benefit from dividing the dosage into twice-daily doses.
Schizophrenia:
(Adolescents 13 to 17 years)
1. Initial: 0.5 mg once daily; dose may be adjusted in increments of 0.5 to 1 mg daily at intervals ≥24 hours to a dose of 3 mg daily.
2. Doses ranging from 1 to 6 mg daily have been evaluated, however, doses >3 mg daily do not confer additional benefit and are associated with increased adverse events. Patients experiencing persistent somnolence may benefit from dividing the dosage into twice-daily doses.