Loxapine vs. Risperdal for Schizophrenia: Important Differences and Potential Risks.

Key takeaways

Loxapine (generic, formerly sold as Loxitane) and Risperidone (Risperdal) are both antipsychotic medications, but they belong to different classes. Loxapine is a first-generation (typical) antipsychotic, while Risperidone is an atypical antipsychotic. Loxapine is primarily used to treat schizophrenia and is available only in generic form. It can cause more movement-related side effects, such as shakiness and stiffness, compared to Risperidone. Risperidone, on the other hand, is used to treat schizophrenia, bipolar disorder, and irritability associated with autism. It is available in various forms, including tablets, dissolvable tablets, and oral solutions. Risperidone is more likely to cause weight gain and changes in sleep patterns. Both medications can cause drowsiness and should not be mixed with alcohol. However, Risperidone has a broader range of uses and forms, making it more versatile for different conditions and age groups.

Loxapine

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Risperidone

(Risperdal)

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Summary for Loxapine

Prescription only

Loxapine is a typical antipsychotic used to treat schizophrenia. Loxapine is taken by mouth, typically once or twice daily. It can cause more movement-related side effects compared with atypical antipsychotics, such as aripiprazole (Abilify). It used to be sold under the brand name Loxitane, which is no longer available. Oral loxapine is now only available as generic capsules.

Indications for Loxapine

Schizophrenia

Pros and Cons for Loxapine

Pros

A good option if other schizophrenia medications haven't worked or have caused bothersome side effects
Dose can be adjusted by your provider based on your response
Available as a lower-cost generic medication

Cons

More likely to cause trouble controlling movements compared to other treatment options
Can raise your heart rate and lower your blood pressure
Risk of developing abnormal muscle movements that might not go away after you stop taking loxapine

Common Side Effects for Loxapine

Drowsiness
Extrapyramidal symptoms (movement problems, such as shakiness, stiffness, excess saliva, and loss of facial expression)
Restless muscles (akathisia)

Warnings for Loxapine

Higher risk of death in older adults
Uncontrollable body movements (tardive dyskinesia)
Neuroleptic malignant syndrome
Falls
Low white blood cell count
Seizures
Vision changes
High prolactin levels

Summary for Risperdal

Prescription only

Risperidone (Risperdal) is an atypical antipsychotic that's used to improve mood, thoughts, and behaviors in people with schizophrenia, bipolar disorder, and autism. It's taken by mouth, typically once or twice daily. Common side effects of risperidone (Risperdal) include sleepiness, movement problems, and weight gain. Risperidone (Risperdal) can interact with some medications, such as certain antidepressants or blood pressure medications. Taking these medications together can make certain side effects worse.

Indications for Risperdal

Schizophrenia - people ages 13 years and older
Manic or mixed episodes associated with bipolar I disorder - people ages 10 years and older
Irritability associated with autism - children ages 5 to 17 years old

Pros and Cons for Risperdal

Pros

Taken by mouth
Available as a pill, dissolving tablet, and liquid
Can be used in both adults and children
Available as a lower-cost generic

Cons

Higher risk of sexual problems, compared to other atypical antipsychotics
Can cause weight gain
Can cause changes to sleep or movement problems
Shouldn't be mixed with alcohol

Common Side Effects for Risperdal

Adults:

Muscle stiffness, muscle tightening, difficulty with movement (25%)
Extreme sleepiness (11%)
Restlessness, trouble remaining still (9%)
Tremor (6%)
Dizziness (6%)
Nausea (5%)
Repetitive movements, abnormal postures (5%)

Children:

Extreme sleepiness (up to 56%)
Dizziness (up to 16%)
Nausea or vomiting (up to 16%)
Stomach pain (up to 16%)
Muscle stiffness, muscle tightening, difficulty with movement (up to 12%)
Heartburn (up to 10%)
Sore throat (up to 10%)

Warnings for Risperdal

Higher risk of death in older adults with dementia-related psychosis
Neuroleptic malignant syndrome
Difficulty controlling muscle movements (tardive dyskinesia)
Weight gain, higher blood sugar, and higher cholesterol levels
High prolactin levels
Changes in blood pressure and higher risk of falls
Risk of infection (from low white blood cell count)
Difficulty concentrating and extreme sleepiness
Seizures
Prolonged and painful erection
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only