Invega Index | Expanded Brand, Generic & Availability ›
Crazy Meds Comprehensive Invega pages

This is our basic overview for Invega, and is a brief summary of what we know about it. Clicking on a “Read more…” link will take you to a page with greater detail. The Comprehensive Invega pages contain the information from all of the “Read more…” pages.

1.  Brand & Generic Names; Drug Class

US brand name:	Invega
Generic name:	paliperidone
Drug class:	Antipsychotics

Read more about Invega’s brand & generic names, and availability

2.  Approved and off-label uses of Invega (paliperidone)

2.1  US FDA approved use(s)

Short- (acute) or long-term (maintenance) treatment of schizophrenia; short-term treatment of schizoaffective disorder, either by itself or with other meds.

2.2  Popular off-label uses

• 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.

Read more of Invega’s approved & off-label uses

3.  Invega’s (paliperidone’s) Pros and Cons

3.1  Pros

• 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.

3.2  Cons

• 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.

3.3  Interesting stuff your doctor probably didn’t tell you

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.
Read more of Invega’s pros, cons, and interesting stuff

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4.  Invega’s (paliperidone’s) Side Effects

4.1  Typical side effects

• Headache
• Drowsiness (Somnolence)
• Dizziness
• Feeling lightheaded
• Weight gain
• Restlessness and trouble sitting still (Akathisia)
• Anxiety
• Faster or irregular heartbeat (Tachycardia and QT interval prolongation respectively)
• And if you are incredibly stupid and drink alcohol you will get drunker*

4.2  Uncommon side effects

• Trouble walking or standing (Dystonia and “coordination abnormal”)
• Drooling
• Fainting (Orthostatic hypotension)
• Extrapyramidal symptoms (probability and severity of EPS increases along with dosage)
• “Unusual eye movements”. - A direct quote from the pharmacy handout.

4.3  Freaky rare side effects

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.
Read more of Invega’s side effects

5.  How to take and stop taking Invega (paliperidone)

5.1  How to take Invega

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 meds¹.
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.

5.2  How to stop taking Invega

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.
Read more about taking and discontinuing Invega

6.  When will Invega (paliperidone) start working?

6.1  How long until Invega starts working

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.

6.2  Chances of Invega working

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.
Read more about Invega’s efficacy & comparisons with other medications

7.  What Invega (paliperidone) is best known for

Being a patent extender of Risperdal.
Read more of Invega’s noted traits, effects, and warnings

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8.  Invega’s (paliperidone’s) half-life & how long until it clears your system

Half-life: An average of 23 hours. Clearance: five days.
Drugs.com’s drug-drug and drug-food interaction checker
Read more about Invega’s pharmacokinetics & noted drug-drug & drug-food interactions

9.  How Invega (paliperidone) works (the best current 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.
Read more about Invega’s pharmacodynamics

10.  Comments

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.
Read more comments
Read consumer/patient comments about & experiences with Invega

11.  Discussion board, PI sheet and other useful links

Crazy Meds’ Invega discussion board
Invega’s Full US Prescribing Information / PI Sheet
Useful Links

Invega Index | Expanded Brand, Generic & Availability ›
Crazy Meds Comprehensive Invega pages

Bibliography

Common and not-so-common misspellings. Because even Google needs help sometimes. And the least we can do is share the creativity expressed by people in their quest for information about neuropsychiatric medications.
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¹ 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.

Date created 10 Jun 2011 - 17:09 Page Creator: girrl88 Last edited by:

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Invega Basic Overview is copyright 2011 girrl88

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