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 the elderly, 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.