Is Risperidone a “Cure All” for OCD?

You have been struggling with OCD for a while, but have been unable to garner real relief. You have tried a plethora of antidepressants, from selective serotonin reuptake inhibitors (SSRIs), like Zoloft, Prozac, and Lexapro, and serotonin and norepinephrine reuptake inhibitors (SNRIs), like Cymbalta and Effexor XR, and to atypical antidepressants, like Wellbutrin and Remeron, but nothing has helped. 

You consistently attend your OCD therapy sessions – cognitive-behavioral therapy (CBT) and exposure-response and prevention (ERP) therapy, but it was not easing your OCD symptoms, so your OCD therapist added SSRIs to the mix. That did not appear to help either, so she replaced SSRIs with SNRIs. When that yielded little-to-no results, the SNRIs were replaced with tricyclic antidepressants. 

But sadly, those did not work either, so now you are at a crossroads – should you try again with another medication or go a completely different route – with alternative treatments? The good news is you can do both! 

Perhaps, you could try an antipsychotic, like risperidone, and alternative treatments or natural remedies, like mindfulness meditation, healthy coping skills and strategies, yoga, OCD workbooks and books, vitamins and minerals, OCD forums, podcasts, and support groups, TMS therapy, acupuncture, and self-help tools, like Impulse Therapy, an online OCD treatment program. 

Risperidone and alternative treatments could be the winning combination that you have been searching for! But before you can make that determination, you will probably want to learn more about risperidone and how it could benefit you, right? Well, look no more, this article will help you better understand risperidone so you can determine if it is the right “fit” for your OCD symptoms.

So, is risperidone a “cure all” for OCD? No.

What is Risperidone?

Risperidone is an antipsychotic FDA-approved to treat certain mental health conditions like: 

• Schizophrenia (a condition that can cause you to see, hear, and/or feel things that are not there, believe untrue things, become irrationally suspicious of people or things, and experience “jumbled” thoughts)
• Bipolar Disorder (a condition that triggers mood swings, ranging from extremely excited or “high” (mania) and an extremely low mood (depression)
• Aggression and/or Agitation in Children (over the age of 5), or Adolescence with Learning Disabilities
• Aggression and/or Agitation in Adults with Alzheimer’s disease

Do I Need a Prescription for Risperidone?

Yes, you do need a prescription to obtain this medication.

What Form Does Risperidone Come In?

Risperidone is available in tablet and dissolvable tablet forms, and in liquid form. If used for schizophrenia, this medication is also offered as an injection.

How Does Risperidone Work?

Risperidone alters dopamine and serotonin (neurotransmitters or chemical messengers) in the brain chemical messengers in the brain. Mental health conditions, like OCD, are linked to low serotonin and dopamine levels. Risperidone “fixes” the low neurotransmitter levels (i.e., serotonin deficiency) by boosting the amount of these neurotransmitters in your brain.

How Fast Does Risperidone Start Working?

Understand that risperidone does start working immediately. It may take several days, weeks, or months for your symptoms (i.e., OCD symptoms) to improve.

What Are the Most Common Side Effects of Risperidone?

The most common risperidone side effects are sleepiness, mobility issues, and headaches/migraines. This medication can also cause you to become hungrier than normal, so you may experience sudden weight gain. 

Common side effects can affect 1 in 10 people, who take risperidone.

Other common side effects include: 

• Daytime sleepiness, insomnia, and other sleep issues 
• Mobility issues – i.e., uncontrollable movements, stiff muscles, slow movements, such as shuffling walk
• Dyskinesia – i.e., shaking and drooling
• Headaches/Migraines
• Increased appetite and/or sudden weight gain
• Stomach or abdominal pain
• Nausea, constipation, diarrhea, and/or vomiting
• Enlarged or swollen breasts, breast pain, and/or leaking breast milk 
• Hormonal changes

Are There Any Serious Side Effects Linked to Risperidone?

Yes, there are. 

However, only 1 in 1,000 people will experience serious side effects. 

Listed below are serious side effects linked to this medication:

• Twitchiness or jerkiness
• Leg edema (swelling), pain, and/or redness 
• Chest pain with breathing difficulties – a possible sign of blood clots
• High temperatures
• Muscle stiffness
• Profuse sweating
• Anxiety
• Excessive saliva

Can I Take Risperidone?

It depends. 

Although risperidone can be safely taken by most adults and children, over the age of 4, it may not be suitable for some people. 

Thus, inform your doctor if you have had an allergic reaction to the ingredients in risperidone or if you suffer from one or more of the following conditions:  

• A Heart Problem (i.e., QT syndrome, arrhythmia, heart murmur, etc.)
• Hypotension (Low Blood Pressure) 
• A History of Strokes or an Elevated Risk of Strokes
• An Inability to Control Your Tongue, Mouth, and/or Face.
• Neuroleptic Malignant Syndrome (A Condition Linked to a High Body Temperature, Muscle Aches & Stiffness, Profuse Sweating, Anxiety, and Excessive Saliva)
• Parkinson’s Disease 
• Dementia
• Low White Blood Cells
• Diabetes 
• Epilepsy
• Prolonged and/or Painful Erection (Over 2 Hours)
• An Inability to Control Your Body Temperature (Overheating)
• Kidney Problems
• Liver Issues
• Increased Risk of Blood Clots or a History of Blood Clots

Can I Take Risperidone If I Am Pregnant?

Yes – with caution. 

Risperidone can be taken during pregnancy; however, the jury is still out as to how safe it is during pregnancy. Limited studies suggest that there could be a small risk to your baby if you decide to take this medication during your pregnancy. However, the risk may be greater if you stop the medication at the beginning, midway, or at the end of your pregnancy. Therefore, it is advised to continue taking it during your pregnancy, if possible. Keep in mind that your doctor may ask you to attend an antenatal clinic if you continue taking risperidone while pregnant.

Can I Take Risperidone While Breastfeeding?

Yes, if you deliver a healthy baby, then you can take risperidone while breastfeeding. 

But keep in mind that risperidone can pass to your baby in small amounts and may lead to side effects in some breastfed babies – although this is rare. Many breastfeeding mothers have used risperidone without any problems. However, if your baby appears unwell, unusually sleepy, or abnormally cranky, contact his or her pediatrician immediately.

What Can Happen If I Take Too Much Risperidone?

If you take too much of (overdose on) risperidone, you may experience the following effects:

• Sleepiness or Lethargy
• Abnormal Body Movements
• Problems Standing and/or Walking
• Dizziness
• Accelerated Heartbeats
• Seizures or “Fits”

Can I Take My Herbal Products with Risperidone?

It is probably best that you do not. 

Taking some herbal remedies and supplements with risperidone, especially those that cause sleepiness and dizziness.

Do not take risperidone with the following herbal remedies due to increased side effects:

• St. John’s Wort
• Ginkgo Biloba

Are There Other Medications That Should Not Be Taken with Risperidone?

Yes, there are. 

Listed below are medications that could interact with risperidone: 

• Rifampicin (an antibiotic used to treat tuberculosis)
• Carbamazepine or Phenytoin (epilepsy medications)
• Itraconazole (anti-fungal medication)
• Sleeping Pills
• Diazepam, Morphine, or Tramadol (opioids)
• Chlorphenamine (an antihistamine) – (risperidone can increase the sedative properties, causing excessive sleepiness or drowsiness)
• Medications that can slow your heart rate
• High Blood Pressure Medications
• Parkinson’s Disease (levodopa) Medications
• Methylphenidate (brain stimulants)
• Diuretics (furosemide or chlorothiazide) used to help you urinate more

Can Risperidone Affect Fertility?

Yes, it can, however, it is rare.

Risperidone-related fertility issues typically occur in less than 1-in-100 people.

Risperidone can alter your hormones, and sometimes, cause sexual issues (in males or females). In females, it can also lead to breakthrough bleeding, prolonged menstrual cycles, heavy periods, absent periods, etc.

What is OCD?

Obsessive-compulsive disorder (OCD) is an anxiety condition that causes unwanted, intrusive, and repetitive thoughts, urges, doubts, mental images, fears, beliefs, emotions (obsessions), and/or ritualistic behaviors (compulsions). OCD is both a powerful and isolating condition, affecting many areas of your health, well-being, and life, in general. 

Stress, anxiety, and trauma are common OCD triggers, although OCD can be genetic, environmental, and/or biological. Obsessions and/or compulsions tend to ramp up during stressful or upsetting times, such as during COVID. The good news is there are numerous effective (traditional and non-traditional) OCD treatments on the market. 

These treatments may involve OCD medications, like SSRIs, SNRIs, tricyclic antidepressants, and antipsychotics, like risperidone, along with lifestyle changes, natural remedies, and self-help tools, like Impulse Therapy.

Can Risperidone Be Used to Treat OCD?

Yes, it can. 

In fact, risperidone may be used “off-label” for treatment-resistant OCD or OCD that has not responded well to more conventional OCD medications, like SSRIs. Keep in mind that this medication is not FDA-approved to treat OCD, although it is sometimes prescribed anyway, if a doctor believes it could be beneficial for OCD and other mental health conditions, such as delusions, delusional parasitosis, depression, Huntington’s disease-related chorea, hypomania, severe agitation, aggression, or psychosis, and Tourette syndrome.

Can Risperidone “Cure” OCD?

Risperidone cannot “cure” OCD, however, it may help ease your OCD symptoms (obsessions and/or compulsions).

Is Risperidone an Effective OCD Treatment?

Yes, risperidone can be effective in some OCD cases. 

According to a 1995 study, risperidone may help treat acute and chronic psychosis, agitation, and cycling accompanying affective illness and may help augment pharmacologic response in OCD. Similarly, a 1996 study found that risperidone augmentation is effective and well-tolerated in people with SRI-refractory OCD. Researchers also found that combining low-dose risperidone with fluvoxamine can be a successful OCD treatment for some people. 

According to a 2008 study, combining, antipsychotics like risperidone, haloperidol, olanzapine, or quetiapine with an SSRI may be more effective than using an SSRI alone, especially in treatment-resistant OCD cases. 

On the flip side, a 2013 study found that exposure-response and prevention (ERP) therapy and SSRIs are more effective for treating OCD than antipsychotics like risperidone. These researchers suggest that an ERP/SSRI therapy approach should be considered when SSRIs are ineffective, due to the fewer side effects and more effective than antipsychotics like risperidone. And, in 2002, researchers discovered that risperidone can trigger OCD in some cases. Researchers believe this stems from the dose and a serotoninergic-dopaminergic imbalance.

What Is It Like to Take Risperidone For OCD?

I have included personal risperidone for OCD reviews because I truly believe that the best way to determine the pros and cons of a medication is best described by OCD sufferers who take the medication or who have taken it in the past. 

Listed below are real-life people who have personal experience with taking risperidone for OCD: 

Amber

“Risperidone worked for my OCD symptoms. The downside? If you want to come off it you will probably have to deal with all your OCD symptoms returning, which is what I am currently dealing with. But in terms of helping me to have a ‘normal life,’ it has been a lifesaver. I only got off of it because I was having weird sleep issues (which apparently only happens to a small percentage of users). But I suggest giving risperidone a chance if your OCD symptoms have gotten really bad.”

Matt

“About a month ago I was prescribed Risperidone 0.5mg for treatment-resistant OCD. I have now been on three different antidepressants (Sertraline, Venlafaxine, Mirtazapine, and Escitalopram) as an OCD monotherapy, all of which have failed. So, my doctor prescribed me risperidone, I have been on this for about 6 weeks. Recently, I have been thinking a lot about how I can tell if the medication is working or not. 

One of my biggest obsessions involves the medication itself. Part of me thinks that the medication is not working, but the other part of me thinks that maybe it just needs more time to work. I am currently on 1mg of risperidone, but I do not think I am getting much benefit out of it. I think there is a benefit just not as much as I would like. I get anxious at the mere thought of talking with my doctor about this. I do not want my doctor to take me off the medication, because I think risperidone is the only thing that gives me any measurable improvement at all.”

Lola

“Risperidone at 2mg worked extremely well for my obsessions. My doctor recently switched me to 150mg of Seroquel as I needed something that would help more with my general anxiety, as well as my OCD symptoms. So, it is still a work in progress for me, but hopefully, the Seroquel will work as well for me as risperidone did. If you are considering taking risperidone for your OCD and you have treatment-resistant OCD and SSRI therapy has not worked, adding risperidone to your OCD treatment plan may be the answer you have been looking for.”

Lindy

“I was taking risperidone for OCD, but recently my doctor decided to take me off of it because of my excessive weight gain. I also recently learned that there are permanent side effects associated with risperidone. I am big into fitness and had started worrying that risperidone would permanently hurt my metabolism, now it looks like that may be true. Does anyone have any information on this?”

References

• Jacobsen F. M. (1995). Risperidone in the treatment of affective illness and obsessive-compulsive disorder. The Journal of Clinical Psychiatry, 56(9), 423–429. Retrieved from https://pubmed.ncbi.nlm.nih.gov/7545159/
• Saxena, S., Wang, D., Bystritsky, A., & Baxter, L. R., Jr (1996). Risperidone augmentation of SRI treatment for refractory obsessive-compulsive disorder. The Journal of Clinical Psychiatry, 57(7), 303–306. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8666572/
• Yoshimura, R., Kaneko, S., Shinkai, K., & Nakamura, J. (2006). Successful treatment for obsessive-compulsive disorder with the addition of low-dose risperidone to fluvoxamine: Implications for plasma levels of catecholamine metabolites and serum brain-derived neurotrophic factor levels. Psychiatry and Clinical Neurosciences, 60(3), 389–393. Retrieved from https://doi.org/10.1111/j.1440-1819.2006.01519.x
• Simpson, H. B., Foa, E. B., Liebowitz, M. R., et al. (2013). Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: A randomized clinical trial. JAMA Psychiatry, 70(11), 1190–1199. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1737168 
• Bandelow, B., Zohar, J., Hollander, E., Kasper, S., Möller, H. J., WFSBP Task Force on Treatment Guidelines for Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, Zohar, J., Hollander, E., Kasper, S., Möller, H. J., Bandelow, B., Allgulander, C., Ayuso-Gutierrez, J., Baldwin, D. S., Buenvicius, R., Cassano, G., Fineberg, N., Gabriels, L., Hindmarch, I., Kaiya, H., … Vega, J. (2008). World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive, and post-traumatic stress disorders – first revision. The World Journal of Biological Psychiatry, 9(4), 248–312. Retrieved from https://doi.org/10.1080/15622970802465807
• Alevizos, B., Lykouras, L., Zervas, I. M., & Christodoulou, G. N. (2002). Risperidone-induced obsessive-compulsive symptoms: A series of six cases. Journal of Clinical Psychopharmacology, 22(5), 461–467. Retrieved from https://doi.org/10.1097/00004714-200210000-00004