Zyprexa vs. Invega
See how Zyprexa and Invega compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both Zyprexa and Invega are atypical antipsychotics for schizophrenia, but Zyprexa also treats bipolar mania and depression while Invega covers schizoaffective disorder.
Zyprexa requires dose titration and comes in tablet, dissolving tablet, and injectable forms, while Invega is a fixed-dose extended-release tablet taken once daily.
Zyprexa carries a higher risk of sedation and weight gain, while Invega carries more risk of insomnia and movement-related side effects like restlessness.
Zyprexa vs. Invega Drug Summary
Zyprexa
Zyprexa (olanzapine) is an atypical antipsychotic approved to treat schizophrenia and bipolar I disorder, including acute mania and long-term maintenance. It is also used for acute agitation and, combined with fluoxetine, for bipolar or treatment-resistant depression. It comes as a tablet, a dissolving tablet, or an injection, usually taken once daily.
Invega
Invega (paliperidone) is an atypical antipsychotic approved to treat schizophrenia and schizoaffective disorder in adults and teens. It is taken as a once-daily extended-release tablet that releases medication steadily through the day using a non-absorbable outer shell. Longer-acting injectable versions are also available for people who prefer less frequent dosing.
Zyprexa vs. Invega Side Effects
Zyprexa
Invega
Zyprexa vs. Invega Dosage
Zyprexa
Invega
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg once daily | At the start |
| Maximum dose | 2.5-10 mg per IM dose | If needed |
| Dose changes | 4 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 3 mg once daily | At the start |
| Maximum dose | 12 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Zyprexa
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg once daily | At the start |
| Maximum dose | 2.5-10 mg per IM dose | If needed |
| Dose changes | 4 increases | As tolerated |
Invega
| STAGE | DOSE | WHEN |
| Starting dose | 3 mg once daily | At the start |
| Maximum dose | 12 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Zyprexa vs. Invega Indications
Zyprexa
Zyprexa treats schizophrenia in adults and teens as well as bipolar I disorder, covering acute manic episodes and long-term maintenance. It is also approved for rapid control of severe agitation and, when combined with fluoxetine, for depressive episodes tied to bipolar disorder or treatment-resistant depression. Some clinicians use it off-label to prevent nausea during chemotherapy.
Schizophrenia in adults and adolescents (13-17)
Bipolar I mania, alone or with lithium/valproate
Maintenance treatment of bipolar I disorder
Invega
Invega treats schizophrenia in adults and teens ages 12 to 17, as well as schizoaffective disorder in adults. It can be used alone or added to mood stabilizers or antidepressants for schizoaffective disorder. Unlike Zyprexa, it does not carry FDA approval for bipolar disorder or depression.
Schizophrenia in adults and adolescents (12-17)
Schizoaffective disorder, used alone
Schizoaffective disorder, added to mood stabilizers or antidepressants
Zyprexa vs. Invega Pros and Cons
Zyprexa
Zyprexa has one of the broadest FDA-approval profiles among antipsychotics, covering schizophrenia, bipolar mania, and depression combinations. It comes in more formulations than Invega, including a fast-dissolving tablet and a short-acting injection for acute situations. Its long track record since 1996 gives clinicians decades of experience with its risks and benefits.
Pros
FDA-approved for bipolar mania, maintenance, and depression, not just schizophrenia
Available as an orally dissolving tablet for people who struggle to swallow pills
Short-acting IM injection option for treating acute agitation quickly
More predictable monthly cost, roughly $440 to $900 without insurance
Cons
Higher risk of significant weight gain and metabolic changes than paliperidone
Long-acting injectable form (Relprevv) requires a restricted REMS monitoring program
Somnolence is very common, reported in more than half of patients in trials
Invega
Invega offers simple, fixed daily dosing without the titration Zyprexa requires, and its extended-release design keeps drug levels steady throughout the day. It is approved for a narrower set of conditions than Zyprexa, focused on schizophrenia and schizoaffective disorder. Longer-acting injectable options make it appealing for people who struggle with daily pills.
Pros
Simple once-daily fixed doses with no titration schedule needed
Extended-release shell gives steady drug levels across the day
Long-acting injectable options dosed monthly, every 3 months, or every 6 months
Lower reported rates of sedation and weight gain than olanzapine
Cons
Not approved for bipolar disorder or depression, only schizophrenia-spectrum conditions
Requires dose adjustments based on kidney function
Higher risk of QT prolongation, requiring caution with other heart-affecting drugs
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.