paliperidone palmitate (Invega Sustenna)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is paliperidone palmitate Invega Sustenna, and how does it work (mechanism of action)?

Invega Sustenna (paliperidone palmitate) is an atypical antipsychotic used to treat schizophrenia. It is a long acting form of paliperidone (Invega). Other atypical antipsychotic drugs include

Atypical antipsychotics differ from typical antipsychotics because they cause a lesser degree of movement (extrapyramidal) side effects and constipation.

The exact mechanism of action of paliperidone is not known, but, like other anti-psychotics, it is believed that paliperidone affects the way the brain works by interfering with communication among the brain's nerves. Nerves communicate with each other by making and releasing chemicals called neurotransmitters. The neurotransmitters travel to other nearby nerves where they attach to receptors on the nerves. The attachment of the neurotransmitters either stimulates or inhibits the function of the nearby nerves. Paliperidone blocks several of the receptors on nerves including dopamine type 2, serotonin type 2, and alpha 2 adrenergic receptors. It is believed that many psychotic illnesses are caused by abnormal communication among nerves in the brain and that by altering communication through neurotransmitters, paliperidone can alter the psychotic state. Invega Sustenna was approved by the FDA in July 2009.

What brand names are available for paliperidone palmitate Invega Sustenna?

Invega Sustenna

Is paliperidone palmitate Invega Sustenna available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for paliperidone palmitate Invega Sustenna?

Yes

What are the side effects of paliperidone palmitate Invega Sustenna?

The most common side effects include

Less common but serious side effects include:

  • Increased risk of stroke in elderly patients with dementia-related psychosis.
  • Neuroleptic malignant syndrome (NMS). NMS is a rare but serious side effect associated with the use of antipsychotics. NMS may result in death and must be treated in the hospital. Signs and symptoms of NMS may include high fever, sweating (diaphoresis), severe muscle stiffness or rigidity, confusion, loss of consciousness, high blood pressure, rapid heartbeat, and changes in your breathing.
  • Extrapyramidal side effects (EPS) include:
    • Dystonia: painful spasms of the oral, throat, or neck muscles that may cause problems with speech, swallowing, and stiff neck.
    • Akathisia: feelings of restlessness or difficulty sitting still.
    • Pseudoparkinsonism: drug-induced Parkinson's symptoms.
  • Tardive dyskinesia (TD). TD usually occurs after long term use of antipsychotics and usually causes movement problems affecting the tongue, lips, jaw, face, and extremities.
  • Metabolic changes including high blood sugar (hyperglycemia), diabetes mellitus, increase in blood cholesterol, and weight gain.
  • High blood levels of prolactin. Prolactin is a hormone that allows the production of breast milk. High levels of prolactin may cause menstrual abnormalities, leakage of milk from the breast, development of breasts in (males gynecomastia), and erection problems in men (erectile dysfunction).
  • Seizures

Medically Reviewed by a Doctor on 7/9/2015

Quick GuideSchizophrenia: Symptoms, Types, Causes, Treatment

Schizophrenia: Symptoms, Types, Causes, Treatment
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