Comparative Pharmacology
Head-to-head clinical analysis: RISPERDAL versus ZIPRASIDONE MESYLATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: RISPERDAL versus ZIPRASIDONE MESYLATE.
RISPERDAL vs ZIPRASIDONE MESYLATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Risperidone is a benzisoxazole atypical antipsychotic that antagonizes dopamine D2 and serotonin 5-HT2A receptors. It also blocks alpha1-adrenergic, alpha2-adrenergic, and histamine H1 receptors.
Ziprasidone mesylate is an atypical antipsychotic with high affinity for serotonin 5-HT2A and dopamine D2 receptors. It also antagonizes 5-HT1D, 5-HT2C, and alpha1-adrenergic receptors, and inhibits serotonin and norepinephrine reuptake.
2-8 mg orally once daily or divided twice daily; maximum 16 mg/day
20 mg intramuscularly (IM) as needed, not to exceed 40 mg/day; oral: 20 mg twice daily with food, titrated up to 80 mg twice daily. Maximum: 160 mg/day oral.
None Documented
None Documented
20 hours (parent drug), 23 hours (active metabolite 9-hydroxyrisperidone). Steady state reached in 5-6 days. Extended in elderly and hepatic/renal impairment.
Terminal elimination half-life is approximately 2.2 hours (range 1.4–3.6 h) for the mesylate salt; clinical context: requires twice-daily dosing.
Renal: 70% (30% as unchanged drug, 40% as metabolites), Fecal/Biliary: 14%
Approximately 20% renal, 80% fecal/biliary. Unchanged drug accounts for <1% of renal excretion.
Category C
Category A/B
Atypical Antipsychotic
Atypical Antipsychotic