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This medication carries a slightly heightened risk of severe and potentially life-threatening side effects, including stroke, heart failure, rapid or irregular heartbeat, and pneumonia, particularly in elderly patients with dementia. It is important to note that this medication is not sanctioned for managing behavior problems associated with dementia. Patients and caregivers should consult with a healthcare provider to evaluate the risks and benefits of this medication, as well as to consider alternative treatments that might be more effective and safer for addressing dementia-related behavioral issues.

For those using paliperidone in conjunction with other medications for depression, it is crucial to thoroughly review the information for all prescribed drugs to understand their combined effects and any additional risks.

You may experience drowsiness, dizziness, lightheadedness, drooling, stomach pain, weight gain, or tiredness when taking this medication. These are common side effects and usually not a cause for concern. If they persist or worsen, consult your healthcare provider. Be cautious as dizziness and lightheadedness can increase the risk of falling, so rise slowly from sitting or lying positions. An empty tablet shell may occasionally appear in your stool, but this is harmless as the active medication has been absorbed.

More serious side effects require immediate attention. If you experience difficulty swallowing, muscle spasms, tremors, mood changes, or interrupted sleep breathing, contact your doctor. This medication can sometimes raise blood sugar levels, which may lead to or worsen diabetes. Be vigilant for symptoms like increased thirst or urination, and if you have diabetes, monitor your blood sugar closely.

Weight gain and increased cholesterol or triglyceride levels can occur, potentially raising the risk of heart disease. Rarely, this medication may cause involuntary movements, known as tardive dyskinesia, which could become permanent. Seek medical advice if you notice any unusual movements. An increase in prolactin levels can lead to symptoms such as unwanted breast milk production in females and reduced sexual ability in males.

Seek emergency medical help for severe side effects like extreme dizziness, fainting, seizures, or symptoms of neuroleptic malignant syndrome (NMS), which include fever, muscle stiffness, severe confusion, and irregular heartbeat. Rarely, males may experience a painful or prolonged erection lasting over four hours, requiring immediate medical attention to prevent permanent issues. Although rare, serious allergic reactions can occur, so seek help if you notice symptoms such as rash, swelling, or trouble breathing. Always communicate any concerns or additional side effects to your healthcare provider.