Before beginning treatment with a potent medication, it may be prudent to research the side effects, possible withdrawal symptoms and other health-related information as thoroughly as possible. Below, these and other topics are expanded and may provide pertinent information for such research and consideration.
Invega (paliperidone) as well as Invega Sustenna are used in the treatment of schizophrenia in adolescents and adults. Other uses include the treatment of depression, schizoaffective disorder and certain other mental health conditions such as mood disorders.
There is a Black Box warning on the label that indicates the drug causes increased mortality in elderly patients with dementia-related symptoms of psychosis.
Invega (paliperidone) refers to the oral pill form taken once every morning. The injectable form, Invega Sustenna (paliperidone palmate), is administered by intramuscular injection once a month, and is a longer-acting medication.
The injectable form of Invega commonly causes reactions at the injection site, as well as somnolence, sedation, dizziness, akathisia, and extrapyramidal disorders. Extrapyramidal disorders are defined as:
The oral form of Invega is taken once daily, and can cause these common side effects:
Less frequent severe side effects may require medical attention, such as:
Since a patient on Invega may have limited ability to articulate what may be happening, careful and continuous monitoring of the person by observers is extremely important.
It is recommended to start taking Invega at the lowest possible dose, and to take as low a dose as possible during maintenance, as coming off the drug may be easier if the accumulated dosages are as minimal as possible.
Some side effects during withdrawal may be quite severe and long-lasting, such as:
Discontinuing Invega should be done in close and regular coordination with the prescribing physician who can adjust the dose at intervals to soften the withdrawals that may present.
Quitting Invega cold turkey is not recommended where possible due to the severity of withdrawals that can occur. (1)
In looking at reasons why discontinuing Invega needs such careful monitoring, one important point to take into account is the possibility that Invega deflects dopamine from certain receptors, and this can reduce mania. However, the body’s response to this is to make new dopamine (D2) receptors.
So, when the drug is reduced, dopamine expression returns, and can appear as returning manic symptoms. In some extreme cases, the patient may become resistant to being guided or following directions in treatment, due to the enchantment of this sensation of enhanced sense of reward. Such unwillingness to take pragmatic guidance can make the situation hard to manage well. Working with a physician who has hospital admission privileges would be advised to regain control in a compassionate way, as stabilization may become necessary, for such extreme cases, in a hospital setting. Where the taper was too rapid or otherwise unstructured, this can be especially relevant to bear in mind.
Once the patient is stabilized, slower tapering can resume, and the patient may be able to transition to becoming medication-free, or to the lowest possible dose that still provides satisfactory quality of life.
It may be easier to find a physician to begin a patient on Invega than to find one who is familiar with helping a patient to come off the drug. When seeking clinical or medical help for tapering, choose a physician with familiarity and confidence in their ability to help.
Below are some common questions asked about Invega, and some other topics that may be helpful in considering stopping or starting Invega.
The Alternative to Meds Center helps patients to make improvements to their mental and emotional health without focusing on medicating or labeling the patient as some permanently broken diagnosis.
As recommended by the APA, there are many investigative actions that can be done before choosing medication for treatment. (3)
However, these investigative efforts have sometimes not been thoroughly done before beginning on a potent medication such as Invega.
In some cases, tapering off medications may be a safe way to proceed with attaining mental health naturally if that is desired. Each of our clients has a unique personal history that must be consulted through every step of the treatment plan that is designed for the person.
One of the most important features of our tapering program is the removal of neurotoxins from the body. This toxic load might comprise many neurotoxic chemicals and substances, heavy metals, accumulated pesticides, drug residues, etc., which when eliminated can bring about many benefits.
Once the cleanse step is complete, typically clients report sleeping better, feeling calmer, brighter, with an improved appetite and other good changes. Using pharmaceutical grade supplements, vitamins, minerals, nebulized glutathione, infra-red sauna, a diet of organic and nutrient-dense foods, chelation and many other therapies, we can help a client to boost their overall health in a positive and non-invasive way.
Inpatient tapering off medication is done under the medical supervision of our medical team, along with our many therapists and caregivers. There is much more information we can provide about our methods and treatment protocols for coming off Invega and improving mental health naturally, by request.
Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona. He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine. Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.