Can Invega kill you?

Invega (paliperidone) is an atypical antipsychotic used to treat schizophrenia and schizoaffective disorder. While many tolerate it well, rare but serious reactions can be life‑threatening.

Neuroleptic Malignant Syndrome (NMS)

• Rare reaction with high fever, muscle rigidity, confusion, unstable blood pressure and heart rate
• Can lead to kidney failure, liver failure, rhabdomyolysis, seizures, and sepsis
• Mortality rate between 5% and 20% if not treated promptly
• Stop Invega and seek emergency care if symptoms develop

Cardiac Risks

• Arrhythmias and QT prolongation can lead to sudden cardiac death
• Avoid in patients with known heart rhythm disorders without close monitoring

Allergic Reactions

• Anaphylaxis may occur with hives, facial or throat swelling, and breathing difficulty
• Requires immediate emergency treatment

Elderly Patients with Dementia

• Increased risk of death from stroke or severe infection
• Not approved for dementia‑related psychosis

Hematologic Effects

• Severe drops in white blood cell count (agranulocytosis) have been reported
• Monitor blood counts during the first months of treatment

Metabolic and Other Serious Effects

• New or worsening diabetes and high blood sugar
• Significant weight gain and lipid changes
• Severe orthostatic hypotension with fainting risk
• Painful or prolonged erections (priapism)

Overdose Findings

In an analysis of over 800 overdose cases, no deaths were reported. Most patients had mild or no symptoms. Supportive care and monitoring are the main treatments.

Potential for Permanent Damage

Tardive dyskinesia (involuntary movements) can sometimes persist even after stopping treatment. Early detection and reporting of movement symptoms can help reduce long‑term risk.

When to Seek Help

• High fever, muscle stiffness, confusion, or sweating (possible NMS)
• Chest pain, palpitations, fainting (possible cardiac issue)
• Signs of severe allergy (hives, swelling, breathing trouble)
• Unusual bruising, infections, or unexplained bleeding

Sources

• Invega Prescribing Information (Janssen Pharmaceuticals)
• Janssen Overdose Analysis Report
• Medscape Invega Safety Profile
• Cleveland Clinic: Neuroleptic Malignant Syndrome Overview