Reported Reactions

Drugs › Atypical antipsychotic

Brand name · Paliperidone palmitate

Invega Sustenna: adverse event reports filed with FDA

23,648 reports list it as a suspect or interacting product, 2009–2026. Class: Atypical antipsychotic.

23,648
reports as suspect product
0.1% of all reports · about 1,412 a year
1,513
reports, 12 months to June 2026
1,249 in the 12 months before
35.8%
marked serious by the reporter
70.7% across the class
2.5%
record death among outcomes, as reported
584 reports · not verified by FDA

Between October 2009 and June 2026, 23,648 adverse event reports received by FDA list the brand name Invega Sustenna (paliperidone palmitate) as a suspect or interacting product. Reports that mention it only as a concomitant medication (597) are left out of every figure here.

In the 12 months to June 2026, 1,513 reports listed it, up 21% from 1,249 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 1,412 reports a year and 0.1% of the 20,646,523 reports in the database, and 3.5% of the reports for the atypical antipsychotic class. How many people take it is not in the data, so a count is not a rate of occurrence.

The reactions recorded most often are off label use (10.9%), drug ineffective (6%) and weight increased (5.9%). A report can list several reactions, so shares add to more than 100%; 972 different terms appear across these reports. Off label use is recorded in 10.9% of these reports, a larger share than in the median atypical antipsychotic drug (6.9%).

35.8% of the reports are marked serious by the reporter (70.7% across the class); 2.5% record death among the outcomes and 17.3% record hospitalisation, as reported. 35.7% of the reports came from other health professionals, and the largest patient age group is 18 to 44 (23.5%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

0137273Jul 2021: 159Aug 2021: 129Sep 2021: 87Oct 2021: 78Nov 2021: 122Dec 2021: 1172022Jan 2022: 97Feb 2022: 151Mar 2022: 273Apr 2022: 132May 2022: 122Jun 2022: 126Jul 2022: 108Aug 2022: 161Sep 2022: 168Oct 2022: 157Nov 2022: 113Dec 2022: 942023Jan 2023: 89Feb 2023: 129Mar 2023: 125Apr 2023: 131May 2023: 99Jun 2023: 102Jul 2023: 105Aug 2023: 95Sep 2023: 86Oct 2023: 110Nov 2023: 106Dec 2023: 1312024Jan 2024: 96Feb 2024: 133Mar 2024: 138Apr 2024: 124May 2024: 180Jun 2024: 116Jul 2024: 95Aug 2024: 112Sep 2024: 102Oct 2024: 102Nov 2024: 81Dec 2024: 492025Jan 2025: 100Feb 2025: 119Mar 2025: 113Apr 2025: 136May 2025: 95Jun 2025: 145Jul 2025: 119Aug 2025: 95Sep 2025: 105Oct 2025: 99Nov 2025: 88Dec 2025: 1682026Jan 2026: 142Feb 2026: 167Mar 2026: 147Apr 2026: 113May 2026: 113Jun 2026: 157

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

01,1552,3102009: 2020092010: 6322011: 98320112012: 1,4222013: 1,47020132014: 1,4432015: 1,59320152016: 1,4972017: 2,31020172018: 1,5572019: 1,47520192020: 1,3352021: 1,35220212022: 1,7022023: 1,30820232024: 1,3282025: 1,38220252026: 839

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Invega Sustenna reports recording the termmedian drug in atypical antipsychotic

  1. Off label useused for a purpose or in a way not on the label10.9%2,566
  2. Drug ineffectivethe medicine did not work as expected6%1,412
  3. Weight increasedweight gain5.9%1,403
  4. Drug dose omissiona dose was missed5.6%1,326
  5. Hospitalisationadmission to hospital5.1%1,202
  6. Gynaecomastiabreast enlargement in men4.4%1,039
  7. Product dose omission issuea dose was missed4.3%1,027
  8. Blood prolactin increased3.4%809
  9. Incorrect dose administeredthe wrong dose was given3.2%766
  10. Inappropriate schedule of drug administrationthe medicine was taken at the wrong times3.1%730
  11. Treatment noncompliancethe treatment was not taken as directed3.1%723
  12. Injection site painpain where the injection was given2.5%600
  13. Schizophreniaschizophrenia2.5%597
  14. Psychotic disordera loss of contact with reality2.5%594
  15. Condition aggravatedthe condition being treated got worse2.2%518
  16. Inappropriate schedule of product administrationthe product was taken at the wrong times2.2%515
  17. Insomniadifficulty sleeping2%469
  18. Depressionlow mood1.9%461
  19. Therapeutic response decreasedthe medicine worked less well1.9%452
  20. Adverse eventan unwanted medical event, type not specified1.9%448
  21. Product use in unapproved indicationused for a purpose not on the label1.9%440
  22. Anxietyanxiety1.8%426
  23. Feeling abnormalfeeling odd or not right1.7%403
  24. Akathisiainner restlessness and an urge to move1.7%402
  25. Fatiguetiredness1.7%402
  26. Tremorshaking1.7%400
  27. Product use issuea problem in how the product was used1.7%397

Top 30 of 972 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 37 drugs in the atypical antipsychotic class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death2.5%584
Life-threatening1.1%249
Hospitalisation (initial or prolonged)17.3%4,081
Disability1.1%269
Congenital anomaly0%8
Other serious18.9%4,473
Not serious64.2%15,172

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 683,680 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 20%2
2 to 110.1%22
12 to 170.9%210
18 to 4423.5%5,564
45 to 649.2%2,175
65 to 741.6%388
75 and over0.5%120
Age not given64.1%15,167

Patient sex

Female30.3%7,174
Male44.7%10,571
Not given25%5,903

Who reported

Physician21.9%5,174
Pharmacist12.8%3,037
Other health professional35.7%8,454
Lawyer0.4%95
Consumer or non-health professional28.7%6,786
Not given0.4%102

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 89.1% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Schizophrenia5,35522.6%
Schizoaffective disorder1,3395.7%
Bipolar disorder9624.1%
Psychotic disorder4541.9%
Bipolar i disorder1610.7%
Schizoaffective disorder bipolar type1410.6%

The indication field is filled in by the reporter and is often blank; shares are of all 23,648 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Invega Sustenna reports
Invega1,6106.8%
Risperdal1,3895.9%
Risperidone7543.2%
Risperdal Consta6662.8%
Invega Trinza4982.1%
Depakote4872.1%
Seroquel3561.5%
Zyprexa3151.3%
Trazodone3061.3%
Abilify2781.2%

Other products listed in reports where Invega Sustenna is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureInvega SustennaAtypical antipsychoticAll reports
Reports as suspect product23,648683,68020,646,523
Share of that pool—3.5%0.1%
Reports, latest 12 months1,513—1,332,454
Marked serious35.8%70.7%57.4%
Death recorded among outcomes, per 1,000 reports2512191
Hospitalisation recorded, per 1,000 reports173304213
Consumer-filed share28.7%34%45.8%
Top term, share of reportsOff label use 10.9%median 6.9%4.1%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the atypical antipsychotic class

DrugName typeReportsLatest 12 monthsMarked serious
Clozapinegeneric73,0233,25293.4%
Abilifybrand54,64562558%
Risperdalgeneric54,45488248.4%
Nuplazidbrand53,7539,60250.6%
Quetiapinegeneric52,3884,19097.6%
Seroquelbrand52,27226562.9%
Clozarilbrand47,9143,08898.4%
Olanzapinegeneric46,8374,08795.3%
Risperidonegeneric44,9622,51176.9%
Aripiprazolegeneric30,1453,10287.8%
Zyprexabrand26,46912178.4%
Quetiapine fumarategeneric19,5681,69790.7%
Invegabrand16,67223835.5%
Latudabrand16,08518340.7%
Rexultibrand12,68363032.3%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Invega Sustenna reports

How many adverse event reports has FDA received for Invega Sustenna?

23,648 reports list Invega Sustenna as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 1,513 of them arrived in the latest 12 months. Another 597 list it only as a concomitant medication.

What reactions are recorded in Invega Sustenna reports?

off label use (10.9%), drug ineffective (6%), weight increased (5.9%), drug dose omission (5.6%) and hospitalisation (5.1%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Invega Sustenna was responsible.

How serious are the reports?

35.8% are marked serious by the reporter. Among the outcomes recorded, 2.5% of reports include death and 17.3% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

other health professional (35.7%), consumer or non-health professional (28.7%) and physician (21.9%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Invega Sustenna rising?

1,513 reports in the 12 months to June 2026, up 21% from 1,249 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Invega Sustenna was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Invega Sustenna?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Invega Sustenna as a suspect or interacting product; reports listing it only as a concomitant medication (597) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.