<p><strong>Cerebrovascular Adverse Reactions, Including Stroke, in Elderly Patients with Dementia-Related Psychosis</strong>: Increased incidence of cerebrovascular adverse reactions (e.g. stroke, transient ischemic attack).<br />
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<strong>Neuroleptic Malignant Syndrome</strong>: Manage with immediate discontinuation of drug and close monitoring.<br />
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<strong>QT Prolongation</strong>: Avoid use with drugs that also increase QT interval and in patients with risk factors for prolonged QT interval.<br />
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<strong>Tardive Dyskinesia</strong>: Discontinue drug if clinically appropriate.<br />
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<strong>Metabolic Changes</strong>: Monitor for hyperglycemia/diabetes mellitus, dyslipidemia and weight gain.<br />
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<strong>Orthostatic Hypotension and Syncope</strong>: Monitor heart rate and blood pressure and warn patients with known cardiovascular or cerebrovascular disease, and risk of dehydration or syncope.<br />
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<strong>Leukopenia, Neutropenia, and Agranulocytosis</strong>: Perform complete blood counts (CBC) in patients with pre-existing low white blood cell count (WBC) or history of leukopenia or neutropenia. Consider discontinuing Paliperidone Palmitate if clinically significant decline in WBC in the absence of other causative factors.<br />
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<strong>Hyperprolactinemia</strong>: Prolactin elevations occur and persist during chronic administration.<br />
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<strong>Potential for Cognitive and Motor Impairment</strong>: Use caution when operating machinery.<br />
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<strong>Seizures</strong>: Use cautiously in patients with a history of seizures or with conditions that lower the seizure threshold.</p>