Long acting paliperidone injection in patient with bipolar affective disorder, current episode manic with psychotic symptoms

Bipolar Disorder is a chronic mental illness characterized by periods of mania, depression, and mixed episodes that often need lifelong medication. The first line of pharmacotherapy includes lithium, valproate, or second-generation antipsychotics. Paliperidone is a medication that works in the brain and is also known as a second-generation antipsychotic. Paliperidone is available as an oral extended-release tablet and a once-monthly extended-release suspension for intramuscular injection. Long-acting injectables (LAIs) are used to reduce the non-adherence of oral medication. Paliperidone is one of the LAI that could be used to treat manic, hypomanic, and mixed episodes in patients with bipolar disorder. Paliperidone LAI reduces the number of relapses, hospitalization, and length of stay. As reported in this case, a patient with a manic episode who received paliperidone LAI showed favourable results after a week-long observation with no signs of extrapyramidal symptoms.