Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.
Paliperidone is an antipsychotic, the main active breakdown product of risperidone (9-hydroxyrisperidone), that blocks dopamine D2 and serotonin 5-HT2A receptors. It is used for schizophrenia and schizoaffective disorder, as extended-release tablets and as long-acting injections given monthly, every three months or every six months. It is sold as Invega, Xeplion and Trevicta, among other names.
Unlike risperidone, paliperidone is cleared mostly unchanged by the kidneys, with little role for CYP2D6, so CYP2D6 variants matter much less. Studies have looked at CYP2D6 and ABCB1 for its levels, and at MC4R and SH2B1 for weight gain. The findings come from a few studies, and there is no CPIC or DPWG guideline.
Every published finding on gene variants and Paliperidone. Upload your DNA file to see which of these rows apply to you.
PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.
MC4R rs17782313: Level 3. Toxicity: Weight gain. 1.
MC4R rs489693: Level 3. Efficacy: Weight gain. 1.
SH2B1 rs3888190: Level 3. Toxicity: Bipolar Disorder, Depressive Disorder, Psychotic Disorder, Schizoaffective disorder. 1.
RABEP1 rs1000940: Level 3. Other: Bipolar Disorder, Depressive Disorder, Psychotic Disorder, Schizoaffective disorder. 1.
Studies of how quickly the body processes this medication.
Studies of how well it worked in people carrying a variant.
Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.
More drugs from the same category
Antipsychotics (class) (Antipsychotics)
Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.
Content updated September 2026.
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