Adding topiramate to risperidone.
- Risperidone is principally metabolized by CYP2D6 to an active metabolite 9-OH-risperidone (paliperidone).
- Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
- Risperidone is principally metabolized by CYP2D6 to an active metabolite.
- This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination.
- Start topiramate according general dosing advice.
- Caution is advised when topiramate is prescribed with other drugs that predispose patients to heat-related disorders, including carbonic anhydrase inhibitors and drugs with anticholinergic activity. 
- KNMP; Informatorium Medicamentorum 2023; Monografie "risperidon" (Dutch)
- Woods SW; Chlorpromazine equivalent doses for the newer atypical antipsychotics J Clin Psychiatry 2003;64:663-667
- The Lundbeck Institute; Psychotropics; Terminal Plasma Half-lives
- Farmacotherapeutisch Kompas - topiramaat (dutch)
- Interactions between risperidone and topiramate on drugs.com
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