Current Pharmacotherapy in the Treatment of Schizoaffective Disorder

The schizoaffective disorder is mainly treated with second-generation antipsychotic drugs as a prophylactic medication. In this sense, the commonly used second-generation antipsychotic drugs are risperidone, olanzapine, quetiapine and aripiprazole. Whereas risperidone has a good antipsychotic, antimanic and therapeutic effect on positive schizophrenic symptoms, olanzapine also exerts a good therapeutic effect on negative schizophrenic symptoms. Quetiapine exerts a good antipsychotic and antidepressant effect. Aripiprazole with a different mechanism of action can improve the outcome of the disease in a long-acting injectable form. Lurasidone is a recently developed antipsychotic drug which can improve cognitive functions as well. Among the mentioned antipsychotic drugs, risperidone causes more often extrapyramidal side effects than the other antipsychotic drugs. When patients suffer from a schizoaffective disorder with a bipolar form, mood-stabilizing drugs can be chosen. Lithium can be administered, because it exerts a secure effect. Other mood-stabilizing drugs are carbamazepine, valproic acid and lamotrigine. Additional pharmacotherapies are sedating neuroleptics, benzodiazepines and anticholinergics or NMDA antagonists to treat the extrapyramidal symptoms. Psychoeducation can improve patient’s adherence to the prophylactic medication. At the end of the chapter, the specific subreceptors, on which new drugs could exert an antipsychotic or antidepressant effect, are summarized according to the preceeding chapters.

Keywords: Anticholinergics, aripiprazole, benzodiazepines, carbamazepine, cariprazine, clozapine, lamotrigine, lithium, lurasidone, mood-stabilizing drugs, NMDA antagonists, olanzapine, quetiapine, risperidone, second-generation antipsychotic drugs, sedating neuroleptics, selective serotonin reuptake inhibitors, valproic acid, ziprasidone.