This is a randomized, double-blind, active-controlled, parallel-group, multicenter comparative study in patients with schizophrenia. The study comprises a screening period of up to 1 week (including periods for washout of psychotropic medications and, if necessary, an oral tolerability test) and a 53-week double-blind treatment period. In the double-blind treatment period, patients will be randomly assigned in equal numbers to receive treatment with either (1) flexibly dosed paliperidone palmitate administered every 4 weeks or (2) flexibly dosed long-acting risperidone administered every 2 weeks. Drug effectiveness and safety will be evaluated periodically throughout the study. Samples for pharmacokinetic evaluation will be collected at designated time points, and a blood sample will be collected at baseline (before the start of the double-blind treatment period) or at any subsequent visit for an optional pharmacogenomic (genetic) analysis. The study hypothesis is that paliperidone palmitate will be as effective as long-acting risperidone in the treatment of patients with schizophrenia. Paliperidone palmitate (25, 50, 75, or 100 milligrams (mg) equivalent) every 4 weeks, or long-acting risperidone 25, 37.5, or 50 mg every 2 weeks of double-blind treatment period, injected into the gluteal muscle (buttocks). Oral risperidone (1-6 mg) first 4 weeks of double-blind period