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paliperidone

✓ Approved

Torrent Pharmaceuticals Limited · DRD2 · 小分子

什么是 paliperidone？

paliperidone 是一种小分子，由Torrent Pharmaceuticals Limited研发。该药已获批，用于治疗相关适应症，给药途径：Oral (PO)。

药物档案

公司Torrent Pharmaceuticals Limited
药物类别小分子
分子靶点DRD2, HTR2A, HTR7
给药途径Oral (PO)
状态Approved
来源： ClinicalTrials.gov, Torrent Pharmaceuticals Limited

作用机制

分子靶点

paliperidone 作用于 3 个分子靶点：

DRD2dopamine receptor D2 (D2DR, D2R)
HTR2A5-hydroxytryptamine receptor 2A (5-HT2A, HTR2)
HTR75-hydroxytryptamine receptor 7 (5-HT7)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

paliperidone 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Psychiatric disordersSchizophrenia✓ Approved

相关研究文献

PubMedBMC psychiatry2026-06-13

Psychotic episode concurrent with interaction with a large language model (llm): a case report.

Başaran Ahmet Selim AS, Coşar Behcet B

Large language model (LLM)-based chat systems generate fluent, second-person, turn-by-turn dialogue that may be anthropomorphized by users. In psychotic-spectrum vulnerability, neutral guidance may be personalized and misread as intentional "signals," potentially lowering the threshold for referential interpretation. A 33-year-old man with schizophrenia and a prior history of persecutory and referential themes had been stable on oral paliperidone 9 mg/day. Approximately 20 days before presentation, he began using ChatGPT for everyday tasks. After querying the system about home and device monitoring, he received generic safety tips (e.g., review microphone/camera/location permissions; check Wi-Fi security; inspect for unknown devices; update operating system; use strong passwords). Within days, he interpreted repeated keywords and typographical emphasis as "hidden signs" and personalized warnings ("my file has been opened"), which escalated into checking behaviors (repeated outlet/device inspections; toggling app permissions) and ultimately led to self-discontinuation of paliperidone in order to "read the signals" more clearly. On Day 0, he was alert and cooperative; persecutory and referential content dominated his thought, with markedly limited insight; Positive and Negative Syndrome Scale (PANSS) total score was 102, Brief Psychiatric Rating Scale (BPRS) score was 58; basic laboratory investigations and a prior brain MRI were unremarkable. Management included psychoeducation emphasizing that similar interpretations had occurred during previous relapses and that abrupt medication cessation likely contributed to symptom escalation; oral paliperidone was reinstated at the prior effective dose. In this case, neutral safety statements produced by an LLM were seemingly reinterpreted as personally targeted messages, likely through the combined influence of anthropomorphic attributions, aberrant salience, and reasoning biases. Incorporating structured assessments of digital media use, including AI chatbot interactions, into routine psychiatric evaluations, explicitly addressing misinterpretations in the therapeutic dialogue, and maintaining continuity of effective antipsychotic treatment may help reduce the risk of similar text-centered personalizations and their contribution to relapse in psychosis. Not applicable.

PMID 42286516
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PubMedCureus2026-06-09

Malignant Catatonia From Paliperidone Withdrawal With Successful Pharmacological Treatment: A Diagnostic and Therapeutic Challenge.

Usman Muhammad M, Shahbaz Muhammad Usman MU, Murtaza Laiba L, Asif Muhammad Zawar MZ et al.

Catatonia is a neuropsychiatric syndrome of psychomotor disturbances occurring in various psychiatric and medical conditions, as well as from adverse effects of antipsychotics. Malignant catatonia is a severe, life-threatening subtype characterized by autonomic instability along with typical catatonia features. It requires immediate treatment with electroconvulsive therapy (ECT) in critical care settings. While oral antipsychotics are well-recognized causes of withdrawal catatonia, cases related to long-acting injectable antipsychotic drugs causing withdrawal catatonia occur less commonly. We present a case of a 43-year-old man with schizophrenia, major depressive disorder, and generalized anxiety disorder who had been on paliperidone. The patient presented to the hospital after missing a dose of paliperidone with symptoms consistent with catatonia. His condition rapidly deteriorated, leading to malignant catatonia. The ECT plan was deferred due to non-availability at the facility and the family's wishes. The patient was treated with high-dose benzodiazepines, which successfully improved his symptoms. He had a prolonged hospital stay due to slow recovery and was discharged on a long taper of benzodiazepines. Paliperidone was resumed as an outpatient because of concerns about rebound catatonia following immediate resumption during hospitalization. This case highlights several atypical features related to catatonia and long-acting injectable antipsychotic medications. It also emphasizes the importance of potential adverse effects from medication nonadherence, especially with long-acting injectable antipsychotics, which can pose diagnostic challenges. Early recognition of malignant hyperthermia, aggressive benzodiazepine dose escalation, and ECT remain cornerstones of successful management. The case further highlights therapeutic challenges in psychiatric emergencies due to patient and system factors.

PMID 42261543
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PubMedCureus2026-06-08

Efficacy of Antipsychotic Augmentation Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis.

Shahtou Ammar A, Omara Hend R HR, Qari Sherin A SA, Alqahtani Rand S RS et al.

Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric condition. While selective serotonin reuptake inhibitors (SSRIs) are a standard treatment, many patients experience an inadequate response to monotherapy. For individuals with treatment-resistant OCD (TR-OCD), antipsychotic augmentation is a commonly utilized pharmacological strategy. This review aimed to systematically review the literature and conduct a frequentist network meta-analysis (NMA) to evaluate the comparative efficacy, safety, and tolerability of first-, second-, and third-generation antipsychotic augmentation in adults with TR-OCD. A systematic search was conducted from database inception to March 2026. Double-blind randomized controlled trials (RCTs) and observational studies evaluating antipsychotic augmentation of ongoing SRI therapy in adults with TR-OCD were included. The primary outcome was the mean change in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) total score. The secondary outcomes included categorical treatment response (Y-BOCS reduction ≥ 35%) and tolerability. Pairwise meta-analyses utilized an inverse-variance random-effects model with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment. The NMA established an empirical treatment hierarchy using surface under the cumulative ranking curve (SUCRA) probabilities. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Forty-three studies (22 RCTs and 21 observational studies) encompassing 890 patients were included. Pairwise meta-analysis of the RCTs demonstrated that, as a class, antipsychotic augmentation was significantly superior to placebo in reducing continuous Y-BOCS scores (standardized mean difference (SMD) = -0.49; 95% CI: -0.99 to -0.00; p < 0.05) and increasing the odds of categorical response (odds ratio (OR) = 2.38; 95% CI: 0.97 to 5.86). The NMA revealed a distinct hierarchy of efficacy: haloperidol exhibited the largest effect compared to placebo (SMD = -1.34; SUCRA = 0.799), followed by olanzapine (SMD = -0.80; SUCRA = 0.596), risperidone (SMD = -0.74; SUCRA = 0.625), and aripiprazole (SMD = -0.57; SUCRA = 0.532). The evidence for quetiapine (SMD = -0.45; SUCRA = 0.450) and paliperidone (SMD = -0.22; SUCRA = 0.356) was less robust and indistinguishable from that of the placebo. Although haloperidol was highly efficacious, its use was limited by poor tolerability. Risperidone and aripiprazole demonstrated the most optimal balance of robust anti-obsessional efficacy and acceptable tolerability. Preliminary data highlighted the potential of third-generation agents, such as brexpiprazole. Antipsychotic augmentation is a highly effective, evidence-based strategy for managing TR-OCD. Based on comparative efficacy and tolerability profiles, risperidone and aripiprazole are the preferred augmenting agents. The routine use of quetiapine should be reconsidered because of its marginal superiority over placebo. Future large-scale active-comparator RCTs are essential to define the long-term metabolic burden and evaluate novel agents to advance precision psychiatry in refractory OCD.

PMID 42255829
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PubMedSchizophrenia (Heidelberg, Germany)2026-06-03

Pharmacological treatment of schizophrenia: Japanese Expert Consensus 2025.

Takekita Yoshiteru Y, Tani Hideaki H, Kawamata Yasushi Y, Katsuki Asuka A et al.

Conventional schizophrenia treatment guidelines do not adequately address all clinically important issues in routine practice. This study aimed to update the 2021 expert consensus of the Japanese Society of Clinical Neuropsychopharmacology (JSCNP) to reflect the current clinical landscape. A total of 154 board-certified psychiatrists from the JSCNP and the Japanese Society of Neuropsychopharmacology (JSNP) evaluated treatment options across 21 clinically relevant situations using a 9-point Likert scale (1 = "strongly disagree"; 9 = "strongly agree"); the response rate was 44%. First-line antipsychotics varied by predominant symptoms: risperidone, brexpiprazole, olanzapine, paliperidone, and blonanserin for positive symptoms; aripiprazole and brexpiprazole for negative symptoms and cognitive impairment; aripiprazole, brexpiprazole, lurasidone, olanzapine, and quetiapine for depression and anxiety; brexpiprazole, aripiprazole, and olanzapine for disorganized thinking; olanzapine and risperidone for excitement and aggression; and aripiprazole, brexpiprazole, and lurasidone for social integration. Brexpiprazole, quetiapine, and aripiprazole were first-line options for patients at high risk of extrapyramidal side effects or diabetes mellitus. Dose reduction or switching was the treatment of choice for tardive dyskinesia. Repeated recurrence, patient request, and poor medication adherence were indications for introducing long-acting injectable antipsychotics. Switching to clozapine was the treatment of choice for treatment-resistant schizophrenia. Adverse effects were the highest-rated factor for both dose reduction and simplification to antipsychotic monotherapy. Second-generation antipsychotics were rated as first- or second-line options in most situations, whereas first-generation antipsychotics were generally rated as third-line. These recommendations provide practical guidance for treatment selection and shared decision-making in clinically challenging situations not adequately addressed by existing evidence alone.

PMID 42230659
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PubMedRivista di psichiatria2026-05-27

Study on independent influencing factors of compliance in patients with schizophrenia treated with paliperidone palmitate injection.

Yu Hu H, Di Yu Y, Jiahuan Li L, Qiusi Li L et al.

Patients with schizophrenia require long-term treatment, and poor medication compliance during therapy is a common issue. Poor compliance can lead to recurrent fluctuations in the patients' disease course, exacerbate its progressive deterioration, severely impact patients' social functioning and quality of life, and thus represents an increasingly serious public health problem. Long-acting injectable antipsychotics (LAIs) are generally considered one of the most effective treatments in psychiatry, which can reduce the substantial economic burden on patients and society, lowering readmission rates, improving patients' quality of life, and decreasing healthcare costs. This study is a retrospective analysis based on follow-up data from patients with severe mental disorders. The study aims to explore the factors influencing medication compliance in schizophrenia patients treated with paliperidone palmitate injection, providing a basis for developing targeted compliance intervention strategies in clinical practice. The study included schizophrenia patients receiving paliperidone palmitate injection and systematically analyzed the impact of variables such as demographic characteristics, caregiver competence, social functioning, disease duration, and the presence of comorbid chronic conditions on medication compliance. Medication compliance in patients with schizophrenia is influenced by the interaction of multiple factors. Among these, age ≥50 years is a core independent risk factor affecting medication compliance, while having a guardian with good caregiving ability serves as an independent protective factor. The impact of a disease duration ≥10 years on compliance approaches statistical significance (p=0.050). A comparison of social functioning across the dimensions of the SDSS revealed that differences in social functioning deficits between the two groups with different levels of medication compliance were only evident in the dimensions of social withdrawal and interest in and concern for the external environment. This suggests that deficits in these specific dimensions of social functioning are also important factors influencing medication compliance in patients.

PMID 42200256
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PubMedTherapeutic advances in psychopharmacology2026-05-22

Patient views on paliperidone palmitate 3-monthly: a cross-sectional questionnaire in UK community mental health teams.

Clark Ivana I, Gee Siobhan S, Taylor David D

Naturalistic studies examining paliperidone palmitate 3-monthly (PP3M) long-acting injection have proven PP3M to be a safe and effective maintenance treatment for patients with schizophrenia. The aim of this study is to explore patients' views and experiences with PP3M. This was a cross-sectional, non-interventional, one-time questionnaire which was designed by pharmacists in collaboration with clinicians experienced in the use of long-acting antipsychotic injections. Eligible patients were adults currently prescribed PP3M who were attending their routine long-acting injection administration appointment at their community mental health team (CMHT). Of 172 patients who were due PP3M during the study period, 68 (39.5%) completed the questionnaire. Of these, 31.3% found PP3M extremely helpful, 43.3% found it very helpful, 17.9% somewhat helpful, 3% slightly helpful and 4.5% not helpful at all. The majority of respondents (83.8%) preferred PP3M over PP1M, with convenience being cited as the main reason for preference (62.9%). The majority reported mild (35.4%) or no injection pain (30.8%) and no new side effects on PP3M (80.6%). For those experiencing side effects, they were largely not considered troubling (24.6%). CMHT contact remained unchanged since switching to PP3M (56.9%). In-person appointments were considered important (33.8%) or very important (35.4%). Most patients either had no preference (40.3%) or were opposed to having a monthly appointment (32.3%). When asked about preferred injection frequency, patients overwhelmingly selected the 3-monthly (62.5%) or 6-monthly option (35.9%). Patients generally reported high levels of satisfaction with PP3M and perceived the treatment to be helpful and well-tolerated, with most expressing a preference for PP3M compared with a 1-monthly injection.

PMID 42170553
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