Abstract: Obsessive-compulsive symptoms (OCS) are common among patients with schizophrenia, with prevalence rates up to 30.3%.1 Although the pathophysiology underlying the presence of OCS in schizophrenia is unknown, it has been suggested their appearance may be a complication of secondgeneration antipsychotics, mainly because of these drugs? combined antagonistic action on D2 and 5-HT2 receptors. We report on a patient with psychosis who developed OCS when treated with paliperidone longacting depot injection.