About Paliperidone Antipsychotic Mechanism of Action of Paliperidone Paliperidone is a benzisoxazole atypical antipsychotic which is a main active metabolite of risperidone. It is reported to be an antagonist at dopamine D2, serotonin (5-HT2), adrenergic a1 and a2 receptors and histamine (H1) receptors. It is used for the acute and maintenance treatment of schizophrenia. Indications for Paliperidone 1.Schizophrenia 2.Severe depression 3.Anxiety 4.Obsessive thoughts Interactions for Paliperidone 1.Increased risk of antipsychotic-related extrapyramidal symptoms when used with central acetylcholinesterase inhibitors. 2.May reduce the therapeutic effect of anti-Parkinson`s agents (dopamine agonist). 3.Serum levels may be reduced by carbamazepine. 4.Concurrent use may increase toxicity of other CNS depressants. 5.Serum levels may be increased by itraconazole. 6.Lithium may increase neurotoxic effects of paliperidone.