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In AMI, IHD, heart failure, conduction abnormality, treatment with antihypertensive medications, conditions pre-disposing to hypotension ie, dehydration, hypovolemia, risperidone is to be used cautiously. Epilepsy, hyperprolactinemia, parkinsonism, old age, renal and hepatic impairment are other conditions which require careful follow-up during risperidone therapy. Monitoring for development of neuroleptic malignant syndrome and tardive dyskinesia is essential and withdraw risperidone if these occur.
Risperidone occasionally prolongs the QT interval. Although confirmed cases of proarrhythmic effect due to risperidone are not yet reported, caution should be exercised.
Use in pregnancy & lactation: There are no adequate and well-controlled studies. Therefore, risperidone should only be used if the potential benefit justifies the potential risk to the foetus/neonate.
Use in children: Safety in children <15 years is not established.
