What is Invega used for?

Invega (paliperidone) is a long‑acting atypical antipsychotic prescribed for certain psychiatric conditions.

Approved Uses

  • Schizophrenia in adults and children 12 years and older
  • Schizoaffective disorder in adults (as monotherapy or with mood stabilizers/antidepressants)

Off‑Label Use

Sometimes used off‑label to manage bipolar disorder symptoms.

Dosage Forms

  • Extended‑release tablets: 1.5 mg, 3 mg, 6 mg, 9 mg
  • Sustenna (monthly injectable): 39–234 mg doses
  • Trinza (quarterly injectable): 273–819 mg doses, after 4 months on Sustenna
  • Hafyera (semi‑annual injectable): 1,092 mg or 1,560 mg doses

How It Works

Paliperidone modulates dopamine and serotonin receptors in the brain to improve positive and negative symptoms of psychosis.

Common Side Effects

  • Extrapyramidal symptoms: tremor, stiffness, restlessness
  • Akathisia (inner restlessness)
  • Sedation or drowsiness
  • Weight gain
  • Tachycardia (fast heart rate)
  • Headache and anxiety

Serious Side Effects

  • Orthostatic hypotension (blood pressure drop on standing)
  • Hyperglycemia (high blood sugar) and diabetes risk
  • Neuroleptic malignant syndrome (fever, muscle stiffness, confusion)
  • Tardive dyskinesia (involuntary movements)
  • Seizures and heart rhythm changes
  • Priapism (prolonged erection)
  • Severe allergic reactions (hives, facial swelling, breathing difficulty)
  • Elevated prolactin levels

Drug Interactions

  • Other QT‑prolonging medications
  • CNS depressants including alcohol
  • Carbamazepine (Tegretol) and divalproex (Depakote)

Before You Start

Tell your doctor if you have:

  • Cardiac conditions, blood pressure abnormalities
  • Diabetes or high blood sugar
  • Kidney impairment
  • History of seizures
  • Lipid abnormalities
  • Parkinson’s disease or Lewy body dementia
  • Pregnancy or plans to breastfeed

Related Medications

  • Abilify (aripiprazole)
  • Risperdal (risperidone)
  • Seroquel (quetiapine)
  • Vraylar (cariprazine)
  • Zyprexa (olanzapine)

Sources

  • Invega Sustena Prescribing Information, Janssen Pharmaceuticals
  • Invega Extended‑Release Tablets Label, FDA
  • Lindenmayer JP, Kaur A. Antipsychotic management of schizoaffective disorder. Drugs. 2016.
  • Gopal S, Xu H. Tardive dyskinesia incidence with paliperidone palmitate. Int J Clin Pract. 2014.