In child and adolescent psychiatry antipsychotics are used in large and increasing quantities for a wide range of disorders and psychopathology, including psychotic, mood and disruptive behaviour disorders.

The European Medicines Agency (EMA) has approved Paliperidone for the treatment of schizophrenia in adolescents from 15 years old.

To present our clinical experience with Paliperidone in the treatment of psychotic symptoms and other psychopathological disorders in adolescents.

To describe with data from clinical practice the potential usefulness of Paliperidone in adolescent disorders beyond Schizophrenia.

Five patients from an outpatient child and adolescent mental health service, on treatment with Paliperidone during 2014, were selected as clinical illustration. Case reports describe personal and family history, clinical presentation, management and treatment, course and outcome, with especial focus in treatment tolerance.

We present 3 males and 2 females, age between 15 and 17 years. Diagnoses were: autism, borderline personality disorder, schizotypal personality disorder, personality disorder not otherwise specified and schizophrenia. Prescribed dose was 3-9 mg/day, and actual mean time of treatment duration is 5,8 months. In 4 cases Paliperidone was initiated as a change from other antipsychotic. There were no adverse effects that required discontinuation and in all cases symptoms improved.

Our clinical experience evidences that Paliperidone is a valuable therapeutic option on behalf of its effectiveness and tolerance.

In our practice the symptoms that respond better to Paliperidone are: hallucinations, reference ideation, irritability, aggression, disorganized behaviour and stereotypies.