Paliperidone

Summary

Paliperidone (CHEMBL1621) is an approved small molecule (ATC N05AX13); indicated across 11 conditions including schizoaffective disorder and psychotic disorder.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: N05AX13
• Indications: 11 conditions
• Clinical trials: 46
• Chemistry: 426.5 Da · C23H27FN4O3

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1621
Name	Paliperidone
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	115237
ChEBI	CHEBI:83804
ATC	N05AX13
Molecular formula	C23H27FN4O3
Molecular weight	426.5
InChIKey	PMXMIIMHBWHSKN-UHFFFAOYSA-N

SMILES: CC1=C(C(=O)N2CCCC(C2=N1)O)CCN3CCC(CC3)C4=NOC5=C4C=CC(=C5)F

IUPAC name: 3-[2-[4-(6-fluoro-1,2-benzoxazol-3-yl)piperidin-1-yl]ethyl]-9-hydroxy-2-methyl-6,7,8,9-tetrahydropyrido[1,2-a]pyrimidin-4-one

ChEBI definition: A member of the class of pyridopyrimidines that is 9-hydroxy-2-methyl-6,7,8,9-tetrahydropyrido[1,2-a]pyrimidin-4-one carrying an additional 2-[4-(6-fluoro-1,2-benzoxazol-3-yl)piperidin-1-yl]ethyl group at position 2.

Also known as: Invega, NSC-759623, Paliperidona, Paliperidone, R-76477, RO-76477, RO76477, PALIPERIDONE, SID90341688, SID144207158, paliperidone, SID170464996

Patent coverage: 625 distinct patent families (1,701 SureChEMBL compound mentions), from 2 matched compound structure(s). One matched structure accounts for 1,591 (94%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 18 (assay-derived). Sample: D(1B) dopamine receptor, Alpha-2A adrenergic receptor, 5-hydroxytryptamine receptor 1B, Alpha-2C adrenergic receptor, Alpha-2B adrenergic receptor, A-type voltage-gated potassium channel KCND3, Sodium channel protein type 5 subunit alpha, 5-hydroxytryptamine receptor 1D, D(1A) dopamine receptor, D(2) dopamine receptor, D(4) dopamine receptor, 5-hydroxytryptamine receptor 2A, 5-hydroxytryptamine receptor 2C, Alpha-1A adrenergic receptor, Histamine H1 receptor, D(3) dopamine receptor, Voltage-gated inwardly rectifying potassium channel KCNH2, 5-hydroxytryptamine receptor 7.

Bioactivity

ChEMBL activities: 23 potent at pChembl ≥ 5 of 25 total. Top 100 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
HTR2A	9.08	Ki	0.83	nM	CHEMBL_ACT_25917681
DRD2	8.8	Ki	1.6	nM	CHEMBL_ACT_25917640
ADRA2C	8.57	Ki	2.7	nM	CHEMBL_ACT_25917708
ADRA2B	8.4	Ki	4	nM	CHEMBL_ACT_25917705
HTR2A	8.28	IC50	5.2	nM	CHEMBL_ACT_18208580
HTR7	8.17	Ki	6.8	nM	CHEMBL_ACT_25917688
HTR1D	8.14	Ki	7.3	nM	CHEMBL_ACT_25917695
DRD3	8.12	Ki	7.5	nM	CHEMBL_ACT_25917660
DRD2	8.08	IC50	8.28	nM	CHEMBL_ACT_18208556
ADRA1A	7.96	Ki	11	nM	CHEMBL_ACT_25917699
ADRA2A	7.96	Ki	11	nM	CHEMBL_ACT_25917710
HTR2C	7.72	Ki	19	nM	CHEMBL_ACT_25917696
DRD5	7.54	Ki	29	nM	CHEMBL_ACT_25917606
HRH1	7.47	Ki	34	nM	CHEMBL_ACT_25917715
DRD4	7.42	Ki	38	nM	CHEMBL_ACT_25917673
HTR1B	6.96	Ki	111	nM	CHEMBL_ACT_25917690
DRD1	6.26	Ki	554	nM	CHEMBL_ACT_25917615
KCNH2	6	IC50	1000	nM	CHEMBL_ACT_15258032
KCNH2	5.9	IC50	1259	nM	CHEMBL_ACT_15258062
KCNH2	5.9	IC50	1259	nM	CHEMBL_ACT_15258092
KCNH2	5.89	IC50	1300	nM	CHEMBL_ACT_2295029
KCNH2	5.89	IC50	1300	nM	CHEMBL_ACT_2295140
KCNH2	5.89	IC50	1288	nM	CHEMBL_ACT_5219031

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

3 approved indications. FDA phase 4, plus an anticancer drug’s labelled cancer uses (which ChEMBL often logs at phase 3).

Indication	Phase	MONDO	EFO
schizoaffective disorder	4	MONDO:0005487	EFO:0005411
psychotic disorder	4	MONDO:0005485	EFO:0005407
mental disorder	4	MONDO:0005084	EFO:0000677

7 diseases in clinical trials (phase 1–3, investigational — not approved indications). Highest ChEMBL trial phase per disease; a non-cancer approved use is occasionally logged at phase 3 here.

Disease (in trials)	Phase	MONDO	EFO
autism	3	MONDO:0005260	EFO:0003758
anxiety	3	MONDO:0011918	EFO:0005230
dementia	3	MONDO:0001627	HP:0000726
depressive disorder	3	MONDO:0002050	MONDO:0002050
bipolar disorder	3	MONDO:0004985	MONDO:0004985
mood disorder	3	MONDO:0005371	EFO:0004247
obsessive-compulsive disorder	2	MONDO:0008114	EFO:0004242

1 further indication record had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 46.

Phase distribution

Phase	Trials
PHASE4	20
Not specified	8
PHASE3	7
PHASE1	5
PHASE2	4
PHASE2/PHASE3	1
PHASE1/PHASE2	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT04478838	PHASE4	RECRUITING	Extended (Alternate Day) Antipsychotic Dosing
NCT07047651	PHASE4	ACTIVE_NOT_RECRUITING	Τhe Combination of Pharmacotherapy With RECOVERYTRSGR and RECOVERYTRSBDGR.
NCT00330863	PHASE4	COMPLETED	Preventing Relapse in Schizophrenia: Oral Antipsychotics Compared To Injectables: Evaluating Efficacy
NCT00592358	PHASE4	TERMINATED	Invega (Paliperidone) for the Treatment of Mania in Children and Adolescents Ages 6-17 With Bipolar Disorder
NCT00761189	PHASE4	COMPLETED	PaliperidoNe Extended-Release [ER] Dosing and Clinical Response in Acute Schizophrenia
NCT00761579	PHASE4	COMPLETED	Paliperidone Extended Release(ER) Effectiveness Study to Evaluate the Objective Symptom Change and Symptomatic Remission
NCT00761605	PHASE4	COMPLETED	Phase 4 Study to Evaluate Efficacy of Paliperidone Extended-Release(ER) in Schizophrenic Participants
NCT00766064	PHASE4	WITHDRAWN	Effects of Paliperidone in Posttraumatic Stress Disorder (PTSD)
NCT00784238	PHASE4	COMPLETED	Efficacy Study of Paliperidone to Evaluate Subjective Change in Well-being and Drug Attitude in Schizophrenic Participants
NCT00937261	PHASE4	UNKNOWN	Contrasting the Brain Effects of Risperidone and Invega With Functional Magnetic Resonance Imaging (fMRI) and Positron Emission Tomography (PET) Scanning
NCT01134731	PHASE4	COMPLETED	Paliperidone and Lithium in the Treatment of Suicidality - Treatment Indication and Epigenetic Regulation
NCT01157351	PHASE4	COMPLETED	15 Month Study for Adults Who Have Been Diagnosed With Schizophrenia and Incarcerated
NCT01193166	PHASE4	WITHDRAWN	Twelve Month Study Comparing Paliperidone Palmitate and Select Oral Antipsychotics in Adults With Schizophrenia Who Have Been Recently Discharged From an Inpatient Psychiatric Hospital
NCT01279213	PHASE4	COMPLETED	Clozapine/Paliperidone Versus Clozapine/Placebo in Resistant Schizophrenia
NCT01399450	PHASE4	COMPLETED	Paliperidone ER(Invega®) on Depressive Symptoms of Schizophrenia Patients
NCT01670071	PHASE4	TERMINATED	A Study to Evaluate the Effect of Oral Paliperidone Extended-Release and Oral Risperidone Immediate-Release on Cognitive Function in Clinically Stable Patients With Schizophrenia
NCT01822730	PHASE4	COMPLETED	A Comparison of Paliperidone and Risperidone for Treatment of Patirnts With Methamphetamine-Associated Psychosis
NCT02146547	PHASE4	COMPLETED	European Long-acting Antipsychotics in Schizophrenia Trial
NCT02307396	PHASE4	COMPLETED	Evaluation of the Necessity of Long-term Pharmacological Treatment With Antipsychotics in Schizophrenic Patients
NCT06060886	PHASE4	UNKNOWN	Multidisciplinary Design to Optimize Schizophrenia Treatment Based on Multi-omics Data and Systems Biology Analysis
NCT00299715	PHASE3	COMPLETED	A Study to Evaluate the Efficacy and Safety of Three Fixed Doses of Extended-release Paliperidone in Subjects With Bipolar I Disorder
NCT00473434	PHASE3	COMPLETED	An Open Label Multicentre Study to Determine the Dose Distribution of Paliperidone ER in Patients With Schizophrenia
NCT00566631	PHASE3	COMPLETED	An Efficacy and Safety Study of Paliperidone Extended-Release (ER) Tablets in Participants With Schizophrenia
NCT00668837	PHASE3	COMPLETED	A 52 Week Open-label Extension Trial Following the Double-blind Efficacy and Safety Study R076477-SCH-305.
NCT01662310	PHASE3	COMPLETED	An Efficacy Study of Paliperidone for the Prevention of Relapse in Participants With Schizophrenia
NCT01795547	PHASE3	COMPLETED	Aripiprazole Once-monthly Versus Paliperidone Palmitate in Adult Patients With Schizophrenia
NCT02374567	PHASE3	TERMINATED	Pharmacovigilance in Gerontopsychiatric Patients
NCT03485417	PHASE2/PHASE3	COMPLETED	Substance Misuse To Psychosis for Stimulants
NCT00257023	PHASE2	COMPLETED	An Exploratory Study on the Safety and Effectiveness of Paliperidone in Patients With Schizophrenia
NCT00632229	PHASE2	COMPLETED	Double Blinded, Placebo-Controlled Trial of Paliperidone Addition in SRI-Resistant Obsessive-Compulsive Disorder
NCT02462473	PHASE2	TERMINATED	A Study to Assess the Clinical Utility of Antipsychotic Medication Levels in Plasma as Determined by Liquid Chromatography-Tandem Mass Spectrometry
NCT03425552	PHASE1/PHASE2	COMPLETED	A Clinical Study to Evaluate the Bioavailability Between Two Products Containing Paliperidone 100 mg in the Form of a Prolonged Release Suspension for Injection in Patients With Schizophrenia Who Are Already Stabilized in This Treatment
NCT03557931	PHASE2	COMPLETED	A Study to Assess the Safety and Efficacy of ASP4345 as Add-on Treatment for Cognitive Impairment in Subjects With Schizophrenia on Stable Doses of Antipsychotic Medication
NCT00796432	PHASE1	COMPLETED	A Study of Dopamine Type 2 (D2) Receptor Occupancy Following a Single Oral Dose of OROS Paliperidone
NCT01607762	PHASE1	COMPLETED	A Study to Compare Capillary and Venous Whole Blood and Plasma Concentrations of Five Antipsychotics
NCT02087579	PHASE1	COMPLETED	Parallel Group, Multiple Dose Pharmacokinetics Study of Five Antipsychotic Medications in Psychiatric Participants
NCT02634463	PHASE1	COMPLETED	Whole Blood and Plasma Sample Collection for the Development of Antipsychotic Immunoassays From Participants Taking Aripiprazole, Olanzapine, Paliperidone, or Risperidone
NCT03730857	PHASE1	COMPLETED	Early Predictors of Poor Treatment Response in Patients With Schizophrenia Treated With Atypical Antipsychotics
NCT01498770	Not specified	COMPLETED	An Observational Drug Utilization Study of Asenapine in the United Kingdom (P08308)
NCT01584466	Not specified	WITHDRAWN	Long Acting Paliperidone in Dually Diagnosed People With Schizophrenia: An Open-label Pilot Study
NCT01825928	Not specified	COMPLETED	An Study of Paliperidone Extended-Release Tablets in the Treatment of Methamphetamine Dependence
NCT02600741	Not specified	COMPLETED	Family Intervention in Recent Onset Schizophrenia Treatment (FIRST)
NCT02893371	Not specified	TERMINATED	Longitudinal Comparative Effectiveness of Bipolar Disorder Therapies
NCT02918825	Not specified	COMPLETED	Long-acting Paliperidone Palmitate Injection and Olanzapine for Schizophrenia
NCT03019887	Not specified	COMPLETED	Correlation Between Cognitive Function and Relapse of Schizophrenia Regarding Dose Reduction
NCT04076371	Not specified	COMPLETED	The Treatment Efficacy of Combination Atypical Antipsychotics With Sertraline in Patients With Schizophrenia

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline, but PharmGKB curates 4 clinical and 9 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).