Under what circumstances should the dose be increased for oral paliperidone extended-release tablets in schizophrenia?

When patients with schizophrenia take paliperidone extended-release tablets orally and experience persistent positive symptoms, worsening negative symptoms, recurrent episodes, social functioning decline, or co-occurring symptoms, dose adjustment or additional medication may need to be considered. Any medication changes must strictly follow medical advice; self-adjustment is strongly discouraged. If symptoms worsen or severe adverse reactions occur, prompt medical attention is recommended.

1. Persistent positive symptoms: Core positive symptoms such as hallucinations, delusions, and disorganized thinking fail to improve, or continue to occur frequently despite treatment, significantly affecting the patient’s daily life and safety. In such cases, doctors may consider increasing the medication dosage to enhance therapeutic effects after evaluation.

2. Worsening negative symptoms: Negative symptoms such as emotional blunting, social withdrawal, and reduced motivation become increasingly prominent, impairing the patient's ability to communicate or participate in social activities. Additional medication may be needed to improve functional status.

3. Recurrent illness: Frequent fluctuations in condition during treatment—symptoms improving and worsening intermittently—or rapid relapse after discontinuation suggest that the current dosage is insufficient for disease control. Doctors may adjust the dosage to maintain stability.

4. Decline in social functioning: The patient experiences reduced ability to perform daily living activities, cannot fulfill work or study responsibilities, or exhibits impulsive or aggressive behaviors. Medication adjustment may be necessary to control symptoms and restore social functioning.

5. Co-occurring symptoms: Presence of comorbid conditions such as depression, anxiety, sleep disturbances, or obsessive symptoms that interfere with treatment outcomes. After comprehensive assessment, dose adjustment may be required.

During treatment, closely monitor symptom changes and attend regular follow-up appointments to report progress to the doctor. Avoid missed doses or unauthorized changes in dosage. Maintain a regular daily routine, avoid staying up late or alcohol consumption, and create a supportive, understanding living environment to promote stable recovery.