Major Research Findings

Paliperidone is an antipsychotic medication used to treat schizophrenia. Several studies have shown that paliperidone is effective compared to placebo. 19 16 Paliperidone is considered a first-line treatment option in schizophrenia. 17 However, paliperidone can cause side effects. 9 13 17 4 15 2 Paliperidone tends to have a lower risk of weight gain and metabolic abnormalities compared to other antipsychotics. 17 Paliperidone has also been shown to be effective in treating schizophrenia in the elderly. 23 26 However, the risk of side effects may be higher in the elderly. 23

Reasons for Side Effects

Paliperidone improves the symptoms of schizophrenia by acting on dopamine D2 receptors and serotonin 5-HT2A receptors. 21 However, these receptors are also involved in various bodily functions such as movement, hormones, and metabolism, so paliperidone can cause a variety of side effects. 21

Common Side Effects

Weight gain

Paliperidone can cause weight gain. 19 17 28 Weight gain is thought to be due to the effect of paliperidone on dopamine receptors. 21

Metabolic abnormalities

Paliperidone can cause metabolic abnormalities. 17 28 Metabolic abnormalities include increased blood sugar, increased cholesterol, and increased triglycerides. 28 Metabolic abnormalities are thought to be due to the effect of paliperidone on dopamine receptors. 21

Extrapyramidal symptoms

Paliperidone can cause extrapyramidal symptoms. 19 17 2 Extrapyramidal symptoms include muscle stiffness, tremors, akathisia, and dystonia. 12 Extrapyramidal symptoms are thought to be due to the effect of paliperidone on dopamine receptors. 21

Prolactin elevation

Paliperidone can cause an increase in prolactin levels. 19 17 1 Prolactin is a hormone that promotes milk production. 21 Elevated prolactin levels can cause breast swelling and milk production in men, and menstrual irregularities and milk production in women. 21

Constipation

Paliperidone can cause constipation. 15 27 Constipation is thought to be due to the effect of paliperidone on muscarinic receptors. 21

Ileus

Paliperidone can cause ileus. 15 Ileus is a condition in which the movement of the intestines stops, preventing food from passing through. 15 Ileus is thought to be due to the effect of paliperidone on muscarinic receptors. 21

Liver dysfunction

Paliperidone can cause liver dysfunction. 8 Liver dysfunction includes elevated liver enzyme levels. 8 Liver dysfunction is thought to be due to the effect of paliperidone on the liver. 21

Neuroleptic malignant syndrome

Paliperidone can cause neuroleptic malignant syndrome. 5 Neuroleptic malignant syndrome is a life-threatening side effect characterized by high fever, muscle stiffness, altered mental status, and autonomic symptoms. 5 Neuroleptic malignant syndrome is thought to be due to the effect of paliperidone on dopamine receptors. 21

Circulatory failure

Paliperidone can cause circulatory failure. 13 Circulatory failure is a condition in which the heart's function is impaired. 13 Circulatory failure is thought to be due to the effect of paliperidone on the heart. 21

Edema

Paliperidone can cause edema. Edema is a condition in which fluid builds up in the body's tissues, causing swelling. Edema is thought to be due to the effect of paliperidone on blood vessels. 21

Side Effect Management

Weight gain management

Diet and exercise are effective in preventing weight gain. 17

Metabolic abnormality management

Diet and exercise are effective in preventing metabolic abnormalities. 17 If blood sugar or cholesterol levels are high, diet and exercise should be followed under the direction of a physician. 17

Extrapyramidal symptom management

If extrapyramidal symptoms develop, anti-Parkinsonian medications may be effective. 17 2 Reducing the dosage of paliperidone may also be effective. 17

Prolactin elevation management

If prolactin levels are elevated, the dosage of paliperidone should be reduced or switched to another antipsychotic medication. 17

Constipation management

To prevent constipation, it is important to eat a diet rich in fiber and drink plenty of fluids. 27

Ileus management

If symptoms of ileus develop, seek immediate medical attention. 15

Liver dysfunction management

If symptoms of liver dysfunction develop, seek immediate medical attention. 8

Neuroleptic malignant syndrome management

If symptoms of neuroleptic malignant syndrome develop, seek immediate medical attention. 5

Comparison of Studies

Commonalities of Studies

Many studies have shown that paliperidone is effective compared to placebo. 19 16 Also, many studies have shown that paliperidone has a lower tendency for weight gain and metabolic abnormalities. 17

Differences in Studies

The effectiveness and severity of side effects of paliperidone may vary depending on the study. 19 16 17 This is because it is influenced by various factors such as the age, gender, severity of illness, dosage, and concomitant medications of the study subjects. 19 16 17

Notes on Application to Real Life

Paliperidone is an effective drug for the treatment of schizophrenia. 17 However, paliperidone can cause side effects. 17 When taking paliperidone, be sure to follow your doctor's instructions carefully and consult your doctor immediately if you experience any side effects. 17

Limitations of Current Research

Research on paliperidone is still not sufficient. 19 16 In particular, further research is needed on long-term side effects and effects on specific populations. 19 16

Future Research Directions

Further research is needed on the long-term side effects of paliperidone and its effects on specific populations. 19 16 Research is also needed on ways to enhance the effectiveness of paliperidone and reduce side effects. 19 16

Conclusion

Paliperidone is an effective drug for the treatment of schizophrenia. 17 However, paliperidone can cause side effects. 17 When taking paliperidone, be sure to follow your doctor's instructions carefully and consult your doctor immediately if you experience any side effects. 17