What is a major concern related to Risperdone (Risperdal) among second-generation antipsychotics?

Among second-generation antipsychotics, a significant concern related to Risperdone (Risperdal) is its potential to elevate prolactin levels. The elevation of prolactin is particularly notable because it can lead to various side effects, including galactorrhea (unexpected milk production), amenorrhea (absence of menstruation), and sexual dysfunction. This hormonal change can also cause psychological distress and impact patient adherence to medication, as some patients may be sensitive to these side effects.

Other second-generation antipsychotics may have varying side effect profiles, but Risperdone is particularly well-known for its association with hyperprolactinemia. This effect arises due to its mechanism of action, which involves blocking dopamine D2 receptors. Dopamine typically inhibits prolactin release; thus, blocking it can lead to increased levels of prolactin in the bloodstream.

While sedation, gastrointestinal upset, and seizure risk are concerns associated with other antipsychotic medications, they are not as distinctive or pronounced as the issue of elevated prolactin levels with Risperdone. Addressing elevated prolactin levels is crucial for both the safety and overall quality of life for patients taking this medication.