side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
Table of Contents (hide)
- 1. Brand & Generic Names; Drug Class
- 2. What is Invega (paliperidone) Used For?
- 3. When Will Invega (paliperidone) Start Working?
- 4. Will Invega Really Work for What You Have?
- 5. How to Take Invega (paliperidone)
- 6. How to Stop Taking Invega (paliperidone)
- 7. Invega (paliperidone) Pros and Cons
- 8. Invega (paliperidone) Side Effects
- 9. What You Really Need to be Careful About with Invega (paliperidone)
- 10. Invega (paliperidone) Half-Life & How Long Until Invega Clears Your System
- 11. How Invega (paliperidone) Works
- 12. Invega (paliperidone) Ratings, Reviews, Comments, PI Sheet, and More
|US brand name: Invega|
|Generic name: paliperidone|
|What is Invega (paliperidone)?|
|Invega (paliperidone) is in the Antipsychotics class of drugs.|
Short- (acute) or long-term (maintenance) treatment of schizophrenia; short-term treatment of schizoaffective disorder, either by itself or with other meds.
- Treatment of bipolar spectrum disorders. (Most likely for management of psychotic symptoms such as hallucinations, delusions, distortions.)
- And probably everything Risperdal is used to treat, with or without official approval.
Like all antipsychotics you’ll feel something the next day. By the time you reach a steady state, usually in 4 to 5 days, you’ll pretty much know if Invega is going to do anything for you. Various studies and trials have shown positive results in 2 to 7 days, with 2 to 4 days being typical.
Invega Sustenna usually takes 4 days.
As the only drug with FDA approval to treat schizoaffective disorder - other than Clozaril’s approval to treat recurrent suicidal behavior - it doesn’t have a lot of competition.
One 6mg tablet in the morning. There, you’re done. Once a day and you’ve started at the recommended dosage. It doesn’t get any freaking easier in the world of crazy meds.
This is where Invega and Risperdal really differ, as Invega comes in only four dosages (1.5, 3, 6 and 9 mg) and you start right out with what you’re probably going to be taking.
Of course you and your doctor could determine that 3mg a day would be a good starting point, which is Janssen’s recommended low-dosage starting point, even though they now make 1.5mg capsules. Sure, why not? I’m all about starting at lower dosages. And if you need to you can go up to 12mg a day in 1.5 to 3mg increments. Three, six, nine and twelve milligrams. I think for many people freedom from choice makes their lives much, much simpler, and simpler is way better.
Or you can get a once-a-month shot of Invega Sustenna. How’s that for simple? Of course, if you get side effects that really suck you’re up shit creak without a paddle, so you probably shouldn’t start with the injection in the highly unlikely event that your doctor suggests you do so.
That’s a good question. When you start at the recommended dosage one would just have to stop taking the one pill a day. Janssen reports not a heck of a lot as happening in Invega’s PI sheet/the PDR. If you were taking 9mg, 12mg (or more) a day, or actually increased from 3mg a day, talk to your doctor about a 3mg a day reduction every five days. Who really knows? This stuff is new. The five days is based on Invega’s half-live of 23 hours.
- Far fewer drug-drug interactions than Risperdal.
- Between the lessened metabolization by the liver (most of Invega gets pissed away) and its being packaged in an OROS trilayer capsule, the people in the trials reported far fewer tummy troubles. Not much from the field. What has been reported confirms what is on the PI sheet, you are less likely to puke with Invega than anything else you’ll see listed on Crazy Meds.
- You have to take it only once a day, compared with taking Risperdal one to four times a day.
- No titration is needed, in that you don’t have to work up to the recommended dosage.
- While Risperdal tablets are small, Invega tablets are about the size of a multivitamin. So if you have trouble swallowing larger tablets (e.g. Depakote, Keppra, Neurontin 800mg tablets, and the larger dosages of Seroquel) you might have problems taking Invega.
- As you should never, ever cut an extended-release tablet of any medication, you can’t get a price break on buying the 6mg tablets and splitting them in half as you can with buying larger dosage tablets of Risperdal and splitting them in half. Let alone to try to help you swallow them.
- Invega is just way more expensive than Risperdal. As many doctors are subject to “if a drug is new it must be better” syndrome, you may be better off with Risperdal, or even a dirt-cheap standard antipsychotic than Invega.
The capsule will pass out looking whole so don’t be surprised by that - it’s what OROS does. Like many of the other atypical antipsychotics, Invega can cause QT interval prolongation. Also, in the clinical trials 12% - 14% of patients receiving Invega reported tachycardia (rapid heartbeat). So if you have a history of heart problems Invega probably isn’t a good idea. Otherwise if you develop cardiac wackiness, an EKG / ECG is a good idea to find out if you have something that is a problem or just annoying.
Being a patent extender of Risperdal.
In-Depth Pros & Cons
- Drowsiness (Somnolence)
- Feeling lightheaded
- Weight gain
- Restlessness and trouble sitting still (Akathisia)
- Faster or irregular heartbeat (Tachycardia and QT interval prolongation respectively)
- And if you are incredibly stupid and drink alcohol you will get drunker
- With Invega Sustenna -
- Injection site issues
- Much higher chances of EPS than the oral version
- Trouble walking or standing (Dystonia and “coordination abnormal”)
- Fainting (Orthostatic hypotension)
- Extrapyramidal symptoms (probability and severity of EPS increases along with dosage)
- “Unusual eye movements”. - A direct quote from the pharmacy handout.
Lactation anyone? Guys, you too can experience the joys of new motherhood. Which isn’t even all that freaky (to anyone who it doesn’t happen to), let alone rare as far as antipsychotics are concerned, but Invega still doesn’t have any weird-ass side effects.
Detailed Invega Side Effects. TMI at times.
It takes 4 - 8 months for your body to be rid of Invega Sustenna - the long-lasting (no shit) injection. So make sure you’re committed to Invega for the long haul.
For the pills - Half-life: An average of 23 hours. Clearance: five days. For Invega Sustenna - Half-life: 25–49 days. Clearance: 125 - 245 days, or 4 - 8 months.
paliperidone Pharmacokinetics Information Overload
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on the pharmacokinetics page.
the current best guess at any rate
So Invega and Risperdal have one of the simplest profiles in which receptors they deal with - mainly the dopamine Type 2 (D2) and serotonin Type 2 (5HT2), with enough of the H1 histamine receptors to help put you to sleep and a light brushing of the α1 and α2 adrenergic receptors thrown in for good measure. They just hit the dopamine receptors harder than most of the other Novel / Atypical Antipsychotics. In some ways Risperdal and Invega act almost like Haldol (halperidol) on steroids, by keeping one’s brain from using too much dopamine and serotonin, thus helping to prevent the positive symptoms in schizophrenia: aggression, conceptual disorganization, hallucinations and hallucinatory behavior, suspiciousness, and unusual thought content. Just replace “conceptual disorganization” with “racing thoughts” and “hallucinatory behavior” with “delusions” and you’ve got symptoms for mania.
More about How Invega Works than You Probably Ever Wanted to Know. AKA paliperidone mechanism/method of action, or pharmacodynamics.
As Invega is merely the active metabolite of Risperdal, so a lot of stuff will be in terms of how it compares with Risperdal.
So if you take Risperdal now or if your doctor thinks that Risperdal is a good fit for you, Invega is going to be better, in terms of side effects, only in that you’re less likely to puke or have other forms of gastric distress. Invega could be better if your liver is mildly impaired (e.g. you have hepatitis), you’re an incredibly poor metabolizer of CYP2D6, and/or you’re taking one or more meds that inhibit CYP2D6.
But if you’re taking Risperdal now, or have taken it in the past, and it didn’t work for you for reasons other than GI-related side effects or CYP2D6 problems, then Invega will be a waste of money and side effects.
An overall zero-to-five rating is absolutely useless information regarding medications. It is little more than a purely emotional and subjective value judgment on a med that has no bearing on how effective a drug is or, more importantly, if Invega (paliperidone) is the right drug for you. So why do I have it? Mainly because it’s cathartic for anyone who is taking or has taken Invega (paliperidone)3. Love it? Hate it? Here’s your chance to let everyone know. You don’t need to be a forum member or anything like that. You get all of one vote which can’t be changed, so make sure it’s what you want.
Get all judgmental about Invega (paliperidone)
Rating 2.6 out of 5 from 11 criticisms
Vote Distribution: 2 – 1 – 2 – 2 – 2 – 2
Extended Comments As if I didn’t go on long enough here.
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
If you have any questions about Invega (paliperidone), please see the Crazy Meds’ Invega (paliperidone) discussion board. I rarely answer questions about meds via e-mail.1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 At some point I may have multiple one-to-ten ratings for individual aspects of medications, such as efficacy and side effects. That could be potentially useful.
4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
|Date created 10 June 2011 at 17:09:23||Page Author: girrl88?||Last modified on Wednesday, 27 November, 2013 at 20:42:54 by some med critic.|
Invega is a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.
Page design and explanatory material by Jerod Poore, copyright © 2004 - 2013. All rights reserved.
Support Crazy Meds by
joining my doubleplusgood circle jerk adding me to your Google+ circle.
Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, and 2013 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on the Crazy Meds Forum.
The information on Crazy Meds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazy Meds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazy Meds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality.
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]