The paliperidone LAI package insert recommends loading doses that result in plasma concentrations approximately equivalent to those of 6 to 12 mg of oral paliperidone ER.7 The package insert also states bridging with oral antipsychotics is not necessary. However, because 4 mg/d oral risperidone is approximately equivalent to 8 mg/d paliperidone ER, recommended loading doses of paliperidone LAI would yield concentrations approximately equivalent to 3 to 6 mg of oral risperidone.9 Especially if the plasma concentrations are closer to 6 mg of paliperidone ER (3 mg of oral risperidone), this may lead to subtherapeutic concentrations in patients who require doses of oral risperidone ≥4 mg/d.