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5-
hydroxytryptamine
receptor 2A
Voltage-
dependent
P/Q-type
calcium channel
subunit
alpha-1A
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-2
Synaptic
vesicular amine
transporter
Sodium-
dependent
serotonin
transporter
Tryptophan
5-hydroxylase 1
Aromatic-L-
amino-acid
decarboxylase
Ca
+
Serotonin
Serotonin
Paliperidone
Ca
+
Serotonin
Paliperidone
Paliperidone
L-Tryptophan
Tetrahydrobiopterin
O
2
5-Hydroxy-L-tryptophan
4a-Hydroxytetrahydrobiopterin
CO
2
Na
+
Na
+
Fe2+
Pyridoxal
5'-phosphate
Gq signaling
cascade
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
↓ Negative symptoms of
schizophrenia
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Paliperidone binds to 5HT2A
where it acts as a
functional antagonist to
reduce negative symptoms of
schizophrenia
↑Cognitive Improvement
Brain
Raphei nuclei producing
serotonergic neurons
Blood vessel -blood brain
barrier
Passive Diffusion
Paliperidone also acts as an
antagonist to Dopamine D1,
D2, Alpha 1A and 1B
receptors
Paliperidone is taken orally
and absorbed from the
gastrointestinal tract.
HTR2A
CACNA1A
CACNB1
CACNA2D2
SLC18A2
SLC6A4
TPH1
DDC
Calcium
Serotonin
Serotonin
Paliperidone
Calcium
Serotonin
Paliperidone
Paliperidone
L-Tryptophan
Tetrahydrobiopterin
Oxygen
5-Hydroxy-L-
tryptophan
4a-
Hydroxytetrahydrobiopterin
Carbon dioxide
Sodium
Sodium
Gq signaling
cascade
HTR2A
CACNA1A
CACNB1
CACNA2D2
SLC18A2
SLC6A4
TPH1
DDC
Ca
+
5-HT
5-HT
Invega
Ca
+
5-HT
Invega
Invega
Trp
BH4
O
2
5-HTP
4aHtHbp
CO
2
Na
+
Na
+
Fe2+
Pyr-5'P
Gq si c
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
↓ Negative symptoms of
schizophrenia
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Paliperidone binds to 5HT2A
where it acts as a
functional antagonist to
reduce negative symptoms of
schizophrenia
↑Cognitive Improvement
Brain
Raphei nuclei producing
serotonergic neurons
Blood vessel -blood brain
barrier
Passive Diffusion
Paliperidone also acts as an
antagonist to Dopamine D1,
D2, Alpha 1A and 1B
receptors
Paliperidone is taken orally
and absorbed from the
gastrointestinal tract.