Risperidone BPSD Licence — MRCPsych Paper B MCQ

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HardOld Age PsychiatryRisperidone BPSD LicenceMRCPsych Paper B

An 82-year-old with moderate to severe dementia has persistent aggression despite assessment and optimised psychosocial and environmental interventions. The aggression presents a risk of harm to other people. If oral risperidone is prescribed for no more than 6 weeks, which dementia subtype would place this use within its UK marketing authorisation?

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Correct answer: E — Alzheimer's disease

The correct answer is **B, Alzheimer's disease**. Risperidone's UK marketing authorisation is narrowly defined: treatment for up to 6 weeks of persistent aggression in moderate to severe Alzheimer's dementia, after non-pharmacological approaches have been unsuccessful, when there is a risk of harm to the patient or others. It is not licensed broadly for all behavioural and psychological symptoms of dementia, such as agitation or psychosis alone. Use in vascular dementia, frontotemporal dementia or dementia with Lewy bodies would be outside this indication. Vascular dementia is a plausible distractor because haloperidol has a separate marketing authorisation that includes Alzheimer's and vascular dementia. Antipsychotics require particular caution in dementia with Lewy bodies because they may worsen motor symptoms and cause severe sensitivity reactions.

Reference: Electronic Medicines Compendium, Risperidone 0.5 mg Film-Coated Tablets, Summary of Product Characteristics, section 4.1, updated 29 January 2026: https://www.medicines.org.uk/emc/product/8208/smpc