Paliperidone
- Oral / IMPaliperidoneInvegaAvailable as depot – monthly dosing for schizophrenia
Mechanism of Action
- Seems to cause transient antagonism of D2 receptors, as well as serotonin 5-HT2A antagonism.
Pharmacology
- Less extrapyramidal adverse effects and less hyperprolactinaemia than first generation antipsychotics.
Clinical Use
- Indications
- Psychosis – schizophrenia, and related disorders
- Acute mania
- Adverse Effects
- Drowsiness
- Postural hypotension
- Prolonged QTc
- Dyslipidaemia
- Weight gain
- Anticholinergic – dry mouth, blurred vision, constipation, urinary retention, delirium
- Extrapyramidal – dystonia, akathisia, parkinsonism, tardive dyskinesia
- Hyperprolactinaemia – gynaecomastia, galactorrhoea, infertility, sexual dysfunction