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paliperidone

✓ Approved

Torrent Pharmaceuticals Limited · DRD2 · Small Molecule

What is paliperidone?

paliperidone is a small molecule developed by Torrent Pharmaceuticals Limited. It is approved for therapeutic indications via oral (po).

Drug Profile

CompanyTorrent Pharmaceuticals Limited
Drug ClassSmall Molecule
Molecular TargetDRD2, HTR2A, HTR7
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Torrent Pharmaceuticals Limited

Mechanism of Action

Molecular Targets

paliperidone acts on 3 molecular targets:

DRD2dopamine receptor D2 (D2DR, D2R)
HTR2A5-hydroxytryptamine receptor 2A (5-HT2A, HTR2)
HTR75-hydroxytryptamine receptor 7 (5-HT7)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

paliperidone is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Psychiatric disordersSchizophrenia✓ Approved

Related Research Articles

PubMedDusunen adam : Bakirkoy Ruh ve Sinir Hastaliklari Hastanesi yayin organi2026-07-16

The knowledge and attitudes of psychiatrists toward antipsychotic long-acting injections in Turkiye.

Fidan Yagmur Sever YS, Calli Sumeyye Yasemin SY, Kizilsert Arda A, Gokce Cengiz C et al.

Schizophrenia is a chronic psychiatric disorder frequently complicated by nonadherence to oral antipsychotics. Long-acting injectable antipsychotics (LAIA) improve adherence and reduce relapse, yet their use differs across countries. This study examined the knowledge, attitudes, and prescribing practices of psychiatrists in Türkiye regarding LAIA treatments. A cross-sectional online survey was conducted between March 2024 and March 2025. The questionnaire, distributed to 1,255 psychiatrists, collected sociodemographic data, clinical workload, and responses to 13 attitude statements. A total of 157 psychiatrists completed the survey and met inclusion criteria. Descriptive statistics and chi-square analyses were performed to assess associations between attitudes and demographic or institutional characteristics. Participants had a mean age of 38 years; 72.6% were female. Most respondents (79.6%) reported routinely considering LAIA therapy. Paliperidone (80.3%) and aripiprazole (47.8%) were the most frequently preferred agents. Positive attitudes were more common among psychiatrists with longer professional experience and those working in institutions with inpatient clinics. More experienced clinicians were significantly less likely to endorse misconceptions, such as the belief that LAIAs limit therapeutic relationships, are costlier than hospitalization, or represent an unpleasant treatment for patients. Attitudes varied across workplace settings: private sector psychiatrists more often expressed caution, particularly regarding first-episode psychosis. Psychiatrists in Türkiye generally recognize the value of LAIAs beyond nonadherent cases, with professional experience and institutional context shaping prescribing patterns. While favorable attitudes predominate, misconceptions and systemic barriers persist. Targeted education, supportive policies, and shared decision-making strategies may promote wider, evidence-based use of LAIAs in clinical practice.

PMID 42459228
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PubMedThe journal of ECT2026-07-15

Pulmonary Aspiration During Electroconvulsive Therapy in a Patient on Multiple Psychotropic Medications: A Case Report and Risk-Stratified Approach to Preprocedural Gastric Ultrasound.

Chauhan Vikas V, Muppuri Ikya I, Richert Allen C AC, Kurnutala Lakshmi N LN

Electroconvulsive therapy (ECT) is usually performed under general anesthesia using a sedative-hypnotic and a short-acting neuromuscular blocker, typically without instrumentation of the airway. We report a case of pulmonary aspiration during ECT in a 27-year-old man on multiple psychotropic medications who was fully compliant with standard American Society of Anesthesiologists (ASA) preoperative fasting (Nil per Os, NPO) guidelines. A postprocedure point-of-care (POC) gastric ultrasound revealed a full stomach with solid contents. The cumulative anticholinergic burden of his medication regimen, including clozapine, benztropine, quetiapine, paliperidone, and prazosin, combined with the recognized association between psychiatric illness and disordered gastric motility, likely contributed to retained gastric contents at the time of induction. We review the limitations of fasting-based risk assessment, the prevalence of residual gastric content in appropriately fasted patients, the evidence supporting POC gastric ultrasound as a decision-support tool, and the practical constraints of equipment availability and operator training. We propose a risk-stratified approach in which preprocedural POC gastric ultrasound is recommended for ECT patients with one or more risk factors for delayed gastric emptying-rather than as a universal, mandatory examination.

PMID 42454711
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PubMedThe world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry2026-07-13

Sexual function despite hyperprolactinemia: a 24-month analysis of paliperidone palmitate versus haloperidol decanoate.

Serretti Alessandro A

Sexual dysfunction is common in schizophrenia and may contribute to poor quality of life and non-adherence. Paliperidone palmitate (PP) and haloperidol decanoate (HD) differ substantially in prolactin liability, but their long-term effects on sexual function are unclear. We compared 24-month ASEX trajectories and prolactin-ASEX associations in the ACLAIMS trial. In participants with ≥1 ASEX assessment, ASEX total score (5-30) was modelled longitudinally with mixed-effects models for repeated measures (MMRM); the binary sexual-dysfunction outcome was modelled with generalised estimating equations (GEE). Prolactin was assessed from months -0.5-24, and prolactin-ASEX associations were examined by sex. 175 participants were included (PP n = 86; HD n = 89). Baseline dysfunction prevalence was 49% in both arms. PP produced higher prolactin throughout follow-up (all p<.001), but ASEX trajectories did not differ significantly. An exploratory month 22-24 window comparison favoured PP (p=.019). Greater prolactin rise from baseline was associated with overall ASEX worsening at month 12 (r = 0.21, p=.013), with concordant but non-significant sex-specific estimates (males r = 0.15; females r = 0.30). Despite higher prolactin with PP, ASEX trajectories were similar between PP and HD. A late PP-favouring signal was observed. Greater within-person prolactin increase was associated with later sexual-function worsening across the cohort.

PMID 42439529
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PubMedNeuropsychiatric disease and treatment2026-06-29

Second-Generation Long-Acting Injectable Antipsychotics: A Comprehensive Assessment of Effectiveness, Safety, and Cost.

Ifteni Petru P, Petric Paula-Simina PS, Popa Andreea Violeta AV, Teodorescu Andreea A et al.

Second-generation long-acting injectable antipsychotics (SG-LAIs) improve adherence, reduce relapse, and enhance outcomes in schizophrenia, yet remain underused. In Romania, data on psychiatrists' views is limited. To assess Romanian psychiatrists' attitudes and prescribing behaviors regarding SG-LAIs, and identify key drivers and barriers to their use. We conducted a cross-sectional questionnaire survey among psychiatrists in urban hospital, outpatient, and private settings, treating more than 1,000 patients with schizophrenia. The survey rated the four SG-LAIs available in Romania (aripiprazole, olanzapine, paliperidone, and risperidone) on efficacy, tolerability, dosing flexibility, monitoring needs, prescribing frequency, and perceived obstacles/facilitators. 80 psychiatrists participated. Aripiprazole LAI received the most favorable ratings, ranking highest for efficacy, safety, patient functioning, ease of administration, guideline alignment, side-effect profile, monitoring requirements, and overall preference. Paliperidone and risperidone were also positively evaluated for dosing versatility, whereas olanzapine generally scored lowest. Main factors encouraging LAI prescription were improved adherence (96.3%) and reduced relapse risk (96.3%), followed by a favorable clinical profile (66.3%). Key barriers included lack of patient trust (57.5%), lack of hospital supply (43.8%), absence of LAI formulations for certain antipsychotics (43.8%), and limited experience (36.3%). Romanian psychiatrists show a strong preference for aripiprazole LAI, with decisions driven mainly by clinical benefits. Reducing patient concerns and system-level limitations-especially availability, indications, and communication- may support increased use of SG-LAIs in everyday clinical care.

PMID 42369073
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PubMedCanadian journal of psychiatry. Revue canadienne de psychiatrie2026-06-29

Healthcare Pattern of Use Before and After Initiating a Long-Acting Antipsychotic Among a Cohort of 6221 Patients With a History of Psychosis.

Stip Emmanuel E, Courteau Josiane J, Brodeur Sébastien S, Chiu Yohann M YM et al.

ObjectiveTo evaluate changes in antipsychotic treatment patterns and healthcare utilization before and after initiation of long-acting injectable antipsychotics (LAI-APs) in a large Québec population cohort, comparing individuals with schizophrenia (SCZ) to those with other psychotic disorders (non-SCZ).MethodWe conducted a retrospective cohort study using linked Québec administrative databases (RAMQ, MED-ECHO, and public drug insurance) to identify 6,221 adults who initiated a LAI-AP between April 2013 and December 2016, after a 12-month LAI-free period. Participants were followed for 12 months before and after the index date. The cohort was stratified into SCZ and non-SCZ, and were further divided by regimen at initiation (LAI only; LAI + clozapine; LAI + other oral antipsychotic). Antipsychotic exposure and health-service usage (hospitalizations, emergency visits, outpatient and community care) trajectories were analyzed weekly using state-sequence analysis; pre- versus post-initiation comparisons used paired statistical tests.ResultsOf 6,221 patients (63.4% male; mean age 41.6 years), initial treatments consisted of paliperidone LAI (55.7%), aripiprazole LAI (21.5%), risperidone LAI (6.9%), first-generation LAI (15.6%), and LAI combinations (0.2%); 40% received LAI only, 5% LAI + clozapine, 55% LAI + an oral antipsychotic. SCZ patients were more often male, economically disadvantaged, and more likely to receive clozapine. After LAI initiation, hospital days fell sharply by almost 70% and outpatient and community-care visits increased substantially. Use of oral antipsychotics decreased overall post-initiation, except for clozapine (which rose) and first-generation oral drugs (which remained stable).ConclusionsIn this real-world Québec cohort, LAI-AP initiation was followed by a marked reduction in hospitalizations and a shift toward outpatient and community care, regardless of diagnosis. Observed differences in sociodemographic and clinical profiles between SCZ and non-SCZ patients-and among SCZ treatment subgroups-suggest the need for tailored care pathways. These findings support LAI-AP effectiveness in reducing healthcare utilization and inform resource planning.

PMID 42370774
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PubMedFrontiers in psychiatry2026-06-25

Manic episode following lurasidone initiation in bipolar I disorder: a case report.

Alzain Nasser M NM, Al-Awad Feras A FA, Alzahrani Saleh A SA, Almsned Fahad M FM

Lurasidone is a second-generation antipsychotic approved for the treatment of bipolar depression. Although effective, antipsychotics may precipitate manic episodes in susceptible individuals. This report aims to describe a unique case of a patient with bipolar I disorder who developed acute mania following lurasidone titration, highlighting the need for vigilance during treatment initiation. We present the case of a 43-year-old man with a history of bipolar I disorder who presented with a severe depressive episode, characterized by depressed mood, insomnia, anhedonia, and suicidal ideation. Laboratory investigations revealed a subtherapeutic serum valproate level of less than 13 µg/mL (reference range: 50-100 µg/mL). Lurasidone therapy was initiated and gradually titrated to 120 mg daily. After 1 week, the patient exhibited increased energy and decreased sleep needs. By the second week, he developed a full manic episode, presenting an elevated mood, irritability, intrusive behavior, and sleeping only one to two hours per night. Following the immediate discontinuation of Lurasidone, alongside the optimization of his sodium valproate dosage and the reinitiation of paliperidone, the patient experienced a dramatic reduction in his manic symptoms. His clinical condition stabilized, and he was subsequently discharged. This case emphasizes the critical importance of close monitoring for manic symptoms following lurasidone initiation in patients with bipolar I disorder and inadequate mood stabilization.

PMID 42344675
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