A case report of exacerbation of extrapyramidal symptoms following the switch from risperidone to paliperidone during valproate therapy

The findings suggest that direct substitution methods, rather than gradual cross-titration, may be safer when switching from risperidone to paliperidone, particularly in patients receiving valproate. Clinicians should be aware of the potential interactions and closely monitor for signs of EPS during such therapy adjustments.