Paliperidone (Invega)

One of the most recent antipsychotic medications on the market is a drug called paliperidone. The brand name for this medication is Invega, and it was approved in December of 2006 for the treatment of schizophrenia in adults. Paliperidone is actually derived from one of the older atypical antipsychotics, risperidone. Studies have shown that this medication is not only very effective, but is also safer and more tolerable than many other antipsychotics 1.

What it’s used to treat

Paliperidone is used to treat both the positive as well as the negative symptoms of schizophrenia. This particular medication has also been shown to be effective in improving the social and personal functioning of the schizophrenic individual. This is especially good news considering how extremely debilitating schizophrenia can be. By helping schizophrenics function better overall, they can lead a much more productive life.

This medication has not yet been approved to treat bipolar disorder. However, it is sometimes prescribed to treat acute manic symptoms in people with bipolar disorder.

How it works

Scientists still do not fully understand how antipsychotic medications actually work in the brain. However, like other similar medications, paliperidone targets specific neurotransmitters, particularly serotonin and dopamine, which are believed to play a major role in schizophrenic symptoms. Paliperidone helps bring these brain chemicals back into balance, thus reducing or alleviating symptoms. It can also help prevent the symptoms from recurring.

How it’s administered

Paliperidone (Invega) is available in tablet form, to be taken orally. These tablets come in three different strengths, and only need to be taken once each day. They are “extended release” tablets, and slowly release the drug for 24 hours.

Potential Side Effects

Like all medication, paliperidone can cause a wide range of side effects. The more common ones are as follows:

  • Feelings of restlessness
  • Tremors
  • Stiff muscles
  • Involuntary movements
  • Rapid heart beat
  • Weight increase
  • Uncontrollable speech
  • Headaches
  • Drowsiness
  • Light-headedness
  • Heartburn
  • Nausea

Some less common symptoms include (but are not limited to) dry mouth, fatigue, increase in saliva, cough, fever, sore throat, heart failure, stroke, rash, problems breathing, and weakness.

While there are many other potential side effects associated with paliperidone, two others which are potentially caused by it are tardive dyskinesia (TD) and neuroleptic malignant syndrome (NMS).

TD can become a permanent condition for some individuals. TD symptoms involve involuntary, random and uncontrollable movements, such as lip smacking, odd tongue or jaw movements, blinking, grimacing, and movements involving the limbs, fingers, toes, upper body or hips.

Neuroleptic malignant syndrome is especially concerning because it can be fatal. Some of the symptoms of NMS include muscle stiffness, changes in one’s mental state, fluctuations in blood pressure or heartbeat, sudden renal failure, tremors, difficulty breathing, dehydration, rapid heartbeat, and extremely high temperature.


As with all medications, there is often a long list of precautions. If you are considering taking paliperidone, be sure to inform your doctor of any current medications, drug allergies, a personal or family history of diabetes, heart problems of any kind, low white blood cell counts, stroke, seizures, stomach problems, suicidal thoughts, difficulties swallowing, breast cancer, low magnesium or potassium levels, Long QT syndrome, Parkinson’s disease, and liver or kidney disease.

Also, if you are pregnant or nursing, or thinking about becoming pregnant, be sure to let your doctor know. Like most other antipsychotics, paliperidone is not recommended for the treatment of psychosis associated with dementia.

written by Dr. Cheryl Lane, PsyD


  1. "Invega™ Approved By FDA as New Treatment for Schizophrenia," Dec 2006