Alleviation of extrapyramidal side effects upon switching from risperidone to paliperidone

Paliperidone is a new second generation antipsychotic; in terms of pharmacology, it is an active metabolite of risperidone. Compared to risperidone, paliperidone should thus show more stable occupation of dopamine receptors in the brain, which on one the hand may lead to increased antipsychotic efficacy, and on the other hand to reduced incidence of adverse extrapyramidal effects. The case report describes alleviation of Parkinson’s syndrome induced by risperidone by switching to paliperidone in a young man with a new occurrence of a paranoid schizophrenia episode. Thanks to its clinical efficacy, paliperidone is ranked among the most successful second generation antipsychotics with reduced extrapyramidal symptomatology.