Paliperidon Cf (Paliperidone)

Paliperidone is an atypical antipsychotic that modulates dopamine pathways implicated in psychotic disorders.

• Schizophrenia: Reduces positive and negative symptoms and helps prevent relapse.
• Schizoaffective disorder: Improves mood and psychotic symptom control.
• Maintenance therapy: Supports long‑term stability after an acute episode.

• Paliperidone acts as a potent antagonist at dopamine D2 and serotonin 5‑HT2A receptors, with additional moderate affinity for α1‑adrenergic, histamine H1 and muscarinic receptors. By blocking D2 receptors in mesolimbic pathways it reduces psychotic symptoms, while 5‑HT2A antagonism helps balance dopamine activity and mitigate extrapyramidal side effects.

Adverse reactions to paliperidone vary in frequency and severity.

Common Side Effects

• Akathisia: inner restlessness and urge to move.
• Weight gain: increase in body mass index.
• Sedation: drowsiness or feeling of being slowed down.
• Dry mouth: reduced salivation.
• Constipation: decreased bowel motility.
• Elevated prolactin: menstrual changes or galactorrhea.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: high fever, muscle rigidity, autonomic instability.
• Tardive dyskinesia: involuntary, repetitive movements.
• Seizures: convulsive episodes, especially in predisposed individuals.
• Orthostatic hypotension: marked drop in blood pressure on standing.
• Cardiac arrhythmias: QT‑interval prolongation.
• Severe hyperglycaemia: marked increase in blood glucose levels.

When prescribing paliperidone, clinicians should assess patient history and monitor for specific safety concerns.

• Cardiovascular assessment: evaluate for QT prolongation and arrhythmias.
• Metabolic monitoring: check weight, glucose and lipid profiles regularly.
• Extrapyramidal symptoms: watch for signs of tremor, rigidity or abnormal movements.
• Prolactin levels: monitor for galactorrhea, menstrual disturbances or sexual dysfunction.
• Pregnancy and lactation: weigh benefits against potential risks; use only if clearly needed.
• Store at ambient temperature: keep below 25°C, protect from moisture and retain in original packaging.

Paliperidone may interact with several drug classes; awareness of interaction severity guides clinical management.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (strongly  ).

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Moderate  

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