Paliperidone extended release (ER) is an atypical antipsychotic that is administered orally once daily to provide consistent plasma drug concentrations over 24 hours in adult patients with schizophrenia. In four well controlled trials, once-daily administration of paliperidone ER 3-12 mg over 6 weeks was more effective than placebo in reducing the positive and negative symptoms experienced by adult patients with schizophrenia, including elderly individuals aged > or =65 years. Patients with schizophrenia treated with paliperidone ER achieved greater improvement in clinically relevant measures of personal and social functioning and disease severity than those who received placebo. In another well controlled trial, paliperidone ER demonstrated superior efficacy to placebo in preventing the recurrence of schizophrenia symptoms. In patients who experienced a recurrence, time to recurrence was delayed with paliperidone ER compared with placebo administration.black triangle Paliperidone ER 3-12 mg/day for 6 weeks was generally well tolerated by patients with schizophrenia in clinical trials.