Male psychiatric patients of all ages may be at risk for Invega side effects including a visible overdevelopment of breast tissue.

Invega is a drug approved to treat schizophrenia in patients at least 12 years old and schizoaffective disorder in adults. Invega is a product of Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson.

Also known by its generic name paliperidone, Invega has been on the market since it was first approved by the FDA in 2006.

Invega is classified as an atypical antipsychotic. Drugs in this class are newer compared to the more established, “typical” antipsychotic medications.

The newer drugs tend to be more effective against negative symptoms while causing fewer movement-related side effects, known as extrapyramidal side effects. They also have a reputation for being more effective in treatment-resistant patients.

Unfortunately, the same mechanism in Invega that treats symptoms may also lead to younger male patients being teased about their “man boobs.”

Part of the way Invega is believed to work has to do with the way it blocks the activity of the neurotransmitter dopamine. That same mechanism of action may be linked to development of gynecomastia in Invega patients.

Reducing dopamine activity can increase the production of a hormone called prolactin, which stimulates breast growth and production of milk.

Prolactin can have that effect in men as well as in women. Normal prolactin levels in men aren’t high enough to cause male breast growth. But if his prolactin levels are artificially raised, the male patient can end up growing breasts and possibly producing breast milk too.

Invega side effects may also include weight gain that can exaggerate abnormal breast development.

Treating gynecomastia that’s related to Invega treatment may only require discontinuing Invega. Most cases of gynecomastia resolve on their own after the cause is removed.

But other cases have been more stubborn, persisting long after the patient has stopped taking the medication. These more refractory cases may require surgery to remove the overdeveloped breast tissue.

Dealing with Invega Side Effects

The physical deformity of gynecomastia is not necessarily a threat to the patient’s health. For some patients, the bulk of the trouble associated with the condition is the resulting emotional harm.

Invega side effects can be particularly detrimental in younger patients, who may be more at risk for teasing and bullying from their peers for having “man boobs.”

One study published in the April 2013 issue of Plastic and Reconstructive Surgery detailed several different negative psychological consequences of gynecomastia that occurred in boys.

Compared to healthy boys who had no abnormal breast enlargement, boys with gynecomastia were more likely to score lower on indicators for mental health, social functioning, and general health.

They also scored lower in measures of self-esteem and showed impairment in emotional areas related to qualify of life. Researchers noted that boys with differing degrees of gynecomastia showed similar negative effects, suggesting that just having gynecomastia at all could bring about these effects.

The effects on self-esteem also appeared to be unrelated to body weight. Although Invega side effects can also include weight gain, losing that weight does not resolve male breast growth in patients who have genuine glandular enlargement.