Most antipsychotics do not require dose adjustment in patients with renal insufficiency, as they do not depend on renal elimination. Paliperidone is the exception, as this medication does not undergo extensive metabolism and is excreted largely unchanged in the urine.

Publication reference : Vermeir, Marc, et al. "Absorption, metabolism, and excretion of paliperidone, a new monoaminergic antagonist, in humans." Drug Metabolism and Disposition 36.4 (2008): 769-779.
Reference URL: https://www.researchgate.net/profile/Geert-Mannens/publication/5625001_Absorption_Metabolism_and_Excretion_of_Paliperidone_a_New_Monoaminergic_Antagonist_in_Humans/links/576bb88308ae5b9a62b61b19/Absorption-Metabolism-and-Excretion-of-Paliperidone-a-New-Monoaminergic-Antagonist-in-Humans.pdf
Publication reference : Levenson, James L. Textbook of Psychosomatic Medicine and Consultation-Liaison Psychiatry. 3rd ed., American Psychiatric Association Publishing, 2019.