Issues with Paliperidone ER

I suffer from Schizoaffective Disorder. I’m taking Paliperidone ER 6mg daily once at bedtime for the last four weeks. Paliperidone ER isn’t curing my racing thoughts although it’s very efficiently curing my bipolar depression. Prior to taking Paliperidone ER I had very severe bipolar depression but now that seems under very much control. Hence, I don’t want to quit taking Paliperidone ER. However, symptoms of disorganized thoughts and racing thoughts are still persisting. Delusional thoughts are almost constantly coming in my mind. When I was taking mix of Olanzapine and Risperidone these symptoms apart from bipolar depression were completely under control.
I also take Olanzapine 2.5mg at bedtime for insomnia. I’m also considering restarting taking low dose of risperidone alongwith aforementioned dosage of Paliperidone ER and Olanzapine. But that’s where problem lies. I read on that there is a moderate drug interaction between Paliperidone and risperidone. Also between Paliperidone and Olanzapine. Also, between Olanzapine and risperidone. Hence, I’m taking risk by taking these medicines together. Is here anyone who has taken Paliperidone alongwith any other antipsychotic. How seriously the moderate interaction between drugs should be taken ? Which are the antipsychotics alongwith which Paliperidone can be mixed. Kindly reply as my health is deteriorating which is seriously affecting my office life.


I was on Invega before - it interacted with the Depakote ER, I felt sick for days. Paliperidone or Invega would probably mix well with another - pine type antipsychotic. Quetiapine, Olanzapine, Asenapine might be some good choices.
I do not know how well Paliperidone would mix with another - done antipsychotic. Examples of-done antipsychotics are Lurasidone, Risperidone, Ileperidone, Better check with a pdoc :wink:

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Great information Wave. There’s actually some great studies on the efficacy and safety of combining -pine’s with -done’s. Many doctors I’ve worked with use this technique to treat treatment-resistant symptoms.

Thanks for your great input!



Thanks Anthony, just trying to contribute and help when i can :smiley:

You do a great job helping Wave. You’d make a great psych nurse or doctor!




lol thanks Anthony - you are the best