Strengths:

Effective in the treatment of manic and mixed states, either as monotherapy or add-on therapy to a mood stabilizer

• Risperidone should be considered as an add-on therapy in breakthrough mania because it has proven efficacy in mania. [ICG Guidelines]
• Following remission of an initial episode of mania, patients should be withdrawn from their benzodiazepine or antipsychotic once the acute episode has resolved. [Australian Guidelines]

Rapid onset of antimanic effect which is independent of antipsychotic effects

• Risperidone was found to be effective for the acute treatment of bipolar mania in a 3-week, double-blinded, placebo-controlled trial. [ICG Guidelines]
• Risperidone improved symptoms of mania significantly more than placebo as early as day 3 and continued to do so throughout the 3-week study. [ICG Guidelines]

Weaknesses:

• One third of patients discontinued risperidone treatment due to a lack of efficacy or adverse events. [ICG Guidelines]