What are the major differences between paliperidone and risperidone?
Paliperidone is actually the major metabolite of risperidone. From the studies that I have seen, it is clearly an effective antipsychotic. It is in an extended-release oral formulation, so it has relatively smooth kinetics. There may be fewer drug-drug interactions with it, because it is the metabolite. Regarding the side-effect profile and efficacy, I am not aware of any differences based on the limited data we have about the drug. It certainly elevates prolactin, which is a major concern with risperidone. It is an effective antipsychotic, but I cannot differentiate it from risperidone.
