Clinical studies to date have shown that risperidone is an effective antipsychotic agent in the treatment of both positive and negative symptomatologies, with a side-effect profile that is superior to standard neuroleptics. It may represent a potentially useful first-line agent in the treatment of schizophrenia, and clinicians may consider switching to risperidone if current neuroleptic therapy yields poor control of symptoms or problematic side-effects, such as extrapyramidal symptoms or tardive dyskinesia. This article discusses the relevant clinical considerations in switching neuroleptics and proposes practical guidelines on issues such as dosing and course of therapy with risperidone.