Risperdal (risperidone) is an antipsychotic medication, marketed by Janssen Pharmaceuticals, that is approved by the U.S. Food and Drug Administration (FDA) to treat schizophrenia and bipolar disorder (manic depression). It may also be used off-label to treat some of the motor and psychiatric symptoms associated with Huntington’s disease.

How Risperdal works

It is not completely understood how Risperdal treats either schizophrenia or Huntington’s. What is known is that it binds to and blocks two types of hormone receptors in the brain, the dopaminergic and serotonergic receptors. Both of these serve many functions in the brain.

Dopaminergic receptors seem to work to regulate neurotransmission (nerve signaling). Inhibiting dopaminergic receptors reduces the amount of dopamine present in the brain, as well as lessening the signal intensity sent by dopamine. For this reason, inhibiting (blocking) dopaminergic receptors is thought to reduce the tremors associated with Huntington’s disease, because these tremors are thought result from overactive nerve signaling in the brain.

Serotonergic receptors are responsible for neural signaling by serotonin. Serotonin is increased in patients with depression, and inhibiting the serotonergic receptors reduces the amount of serotonin present as well as blocking the signals sent by serotonin.

Inhibiting both dopaminergic and serotonergic receptors is thought to decrease the overactive signaling in the brain that causes chorea (tremors), as well as treating the psychiatric depression and apathy that can be common symptoms of Huntington’s.

Treating Huntington’s disease with Risperdal

A small, retrospective study of Risperdal’s use with Huntington’s patients was published in the Annals of Clinical Psychiatry. The motor, psychiatric, and cognitive function of 17 patients taking Risperdal and 12 who were not taking any psychiatric medications were compared across one year. Patients being treated with Risperdal were found to significantly improve in psychiatric symptoms and in motor stabilization. Those who served as controls were stable psychiatrically, but showed worsening motor symptoms.

Other information

Possible side effects of Risperdal treatment include aggression, agitation, and anxiety.  Loss of balance, difficulty sleeping, and skin rash may also be seen.

An off-label therapy is one thought to help patients with conditions that the medicine has not been approved to treat. Although its use is legal, pharmaceutical companies may not market a medication for an off-label use.

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