Paliperidone is an atypical antipsychotic mainly used to treat schizophrenia and schizoaffective
disorder. In a global comparison of 15 antipsychotic drugs, Paliperidone was ranked fifth and
demonstrated standard-high effectiveness.
Paliperidone is sold under the brand name Invega, Invega Sustenna, Invega Trinza among others.
Food and Drug Administration (FDA) was approved by the Paliperidone (for treating schizophrenia in
2006 and for schizoaffective disorder in 2009. Paliperidone’s long-acting injectable form is sold in
U.S. and Europe, was approved by the FDA in 2009.
Dosage and administration
It is a sold as a long-acting injectable formulation of paliperidone palmitoyl ester. After an initial
titration period, it is given once-every 28 days. It is also sold as extended release tablets in 1.5mg,
3mg, 6mg, 9mg, as IM injectable suspension prefilled syringe in 39mg, 78mg, 117mg, 156mg, 234mg
take every month and IM injectable suspension prefilled syringe 273mg, 410mg, 546mg, 819mg to
taken once every three months. In the treatment of Schizophrenia, the dose is set at 6 mg taken
orally every morning. This dose can be titrated in increments of 3 mg a day but they have to spaced
at least 5 days apart. If using IM, sustained-released 1-month, 234 mg in deltoid on treatment day 1,
the dose on day 8 has to be 156 mg. this is followed by maintenance dose is 117 mg IM once a
month. For those who need IM, sustained-released 3-months must have be adequately treated with
for 4-month with paliperidone before starting the sustained-released 3-months dose.
When taken as a monotherapy for treating Schizoaffective Disorder, or and as an adjunct to mood
stabilizers or antidepressants, the dose is 6 mg orally in the morning. If the dose exceeds 6mg a day,
titration may not be necessary. If the dose has to be increased above 6mg/day, they have to be
increased at 3 mg per day at intervals of 4 days or more. For more detailed instructions for individual
cases, the physician must be consulted.
The price of Paliperidone
In India, the cost of 7 tablets of 6mg cost the consumer around USD 0.6 and a supply for 10 tablets of
extended release of 6mg strength cost USD 1.3. and the 150 Mg Injection cost around USD2.5. this
medicine is significantly more expensive the West. In the USA, the consumer pays an average retail
price of $837.39 for supply of 30 tablets of 6mg strength.
How does Paliperidone work?
Paliperidone works in the brain to treat schizophrenia and schizoaffective disorders. It is a second-
generation antipsychotic (SGA) or an atypical antipsychotic and similar to other atypical
antipsychotic agents, its effect is attributed to the antagonism of brain dopamine D2 and serotonin
5-HT2A receptors. As a result of the antagonism, it rebalances dopamine and serotonin levels in the
brain leading to improved thinking, better mood, and behaviour.
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