Does Escitalopram Interact With Risperidone? (3 Risks)

By Dr Drielli Vital-Fujii (PhD)

Page last updated: 02/01/2024 | Next review date: 02/01/2026

Author bio

Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.

Dr Drielli Vital-Fujii’s Highlights:

Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.

PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)

Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil

Professional Experience:

2012 – 2018 Project manager at University of São Paulo – Pharmacy Department

Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.

2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.

She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).

2018 – 2019 Faculdades Oswaldo Cruz

Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.

2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department

She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.

2023-2023 UniPiaget – University Center.

Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.

Education:

2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo

2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo

2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo

2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes

The leading publications of Dr Drielli Vital-Fujii are:

Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.

Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.

Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.

Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.

Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.

Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.

Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.

Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.

Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.

You can view some of Dr Drielli’s work below and links to her professional profile.

Orcid: https://orcid.org/0000-0001-9270-0466

Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii

Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000

Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR

Linkedin: linkedin.com/in/driellivital

Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital

CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists

Dr Drielli Vital-Fujii (PhD)

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In this article, we will discuss whether escitalopram and risperidone interact with each other, the potential risks of this combination, and what precautions you should take. Lastly, when to seek professional advice from your doctor.

Does escitalopram interact with risperidone?

Yes, escitalopram interacts with risperidone. Escitalopram and risperidone belong to different classes of medications, but both tackle mental health conditions. When taken together, you may experience potential interactions and side effects.

Escitalopram is a selective serotonin reuptake inhibitor (SSRI) prescribed for anxiety and depression. On the other hand, risperidone is an antipsychotic for treating bipolar disorder and schizophrenia. Your doctor may sometimes prescribe both medicines despite the risk of drug interactions.

Nevertheless, strict monitoring and adherence to your treatment plan are necessary. Escitalopram is usually the antidepressant of choice that will cause fewer adverse effects (1).

What are the potential risks of combining escitalopram with risperidone?

Concomitant use of escitalopram and risperidone will cause adverse consequences due to their effect on the brain and heart. Unless prescribed by your doctor and determined safe, these drugs can cause the following risks to your health:

Serotonin syndrome

The risk of developing serotonin syndrome increases when an antidepressant interacts with another drug that affects the neurotransmitters in your brain. SSRIs such as escitalopram can cause excess serotonin in the body. Signs and symptoms can range from mild to fatal, which include:

Muscle twitching
Restlessness
Insomnia
Confusion
Rapid heart rate
High blood pressure
Diarrhea

Life-threatening symptoms that need immediate intervention are tremors, high fever, and seizures. Although serotonin syndrome is a rare side effect, it can be fatal to a patient. It is essential to be aware of its early signs to prevent the worsening of your condition (2).

QT prolongation

The lengthening of the QT interval will lead to irregular heart rhythm or arrhythmia. It is a rare side effect but can occur with many associated drugs. Atypical antipsychotics like risperidone have a lower risk at therapeutic doses.

However, SSRIs have a high risk of affecting corrected QT (QTc) prolongation. Therefore, if you are taking both these drugs, you should discuss with your healthcare provider your risk of developing QTc prolongation. This condition can lead to fatal consequences, especially for people with heart conditions, 65 years above, and electrolyte disturbances (3).

Increased sedation and other side effects

Escitalopram and risperidone both act on the brain but have their own side effects. However, some side effects may be exacerbated if they are taken together. Escitalopram and risperidone have sedative effects, which may cause tiredness, sleepiness, dizziness, and difficulty focusing.

Moreover, the extrapyramidal effect increases in occurrence due to the rise in levels of risperidone when combined with escitalopram (1). Other side effects of risperidone and escitalopram that you may experience are weight changes and muscle twitching.

What precautions and recommendations should you take with escitalopram and risperidone?

Since the combination of escitalopram and risperidone can lead to serious drug interactions, take them only if your doctor finds it necessary. Medical supervision will be crucial in reducing any complications.

Remember the following precautions while taking both medications:

If you have preexisting heart conditions while taking escitalopram and risperidone, regularly monitor and follow up with your doctor.
Avoid driving or operating heavy machinery when feeling drowsy, dizzy, and with stiff muscles.
Avoid drinking and taking recreational drugs. It causes complications while taking antidepressants and antipsychotics.
Inform your doctor if you are pregnant or planning to get pregnant before taking escitalopram and risperidone (4,5).

It is essential to consult your healthcare provider when taking a combination of escitalopram and risperidone. Although these medications may cause interactions, you can achieve a safe and effective outcome when handled correctly.

Remember the following points in coordinating with your healthcare provider:

Discuss your medical history and the medications you take with your doctor.
Your doctor can guide you according to your needs. Necessary dose adjustments will be made to create an effective treatment plan.
Ask your doctor about the benefits and risks of your treatment plan
Consult your healthcare provider before starting or stopping any medications.
Follow up with your doctor regularly about the side effects you experience (4,5).

Conclusion

In my experience, drug interactions between medications such as escitalopram and risperidone have a wide range of effects on an individual. Therefore, consulting your healthcare provider is crucial for optimal outcomes. Familiarizing yourself with the precautions and risks of this drug combination is the best way to manage your health.

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References

1.-

Rao P, Bhagat N, Shah B, Bazegha M. Interaction between escitalopram and risperidone. Indian J Psychiatry. 2005 Jan-Mar;47(1):65–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2918324/

2.-

Mayo Clinic Staff. Serotonin Syndrome [Internet]. Mayo Foundation for Medical Education and Research; 2022 [cited 2023 Oct 28]. Available from: https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

3.-

Dietle A. QTc Prolongation With Antidepressants and Antipsychotics [Internet]. US Pharmacist; 2015 [cited 2023 Oct 28]. Available from: https://www.uspharmacist.com/article/qtc-prolongation-with-antidepressants-and-antipsychotics

4.-

Allergan USA, Inc. Lexapro (escitalopram oxalate) [Internet]. U.S. Food and Drug Administration; 2017 [updated 2020 Feb 13; cited 2023 Oct 28]. Available from: https://www.fda.gov/media/135185/download

5.-

Janssen Pharmaceutical Ltd. Risperdal (risperidone) [Internet]. U.S. Food and Drug Administration; 2009 [cited 2023 Oct 28] Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020272s056,020588s044,021346s033,021444s03lbl.pdf

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Does Escitalopram Interact With Risperidone? (3 risks)