Schizoaffective Disorder: Treatment Considerations

Abstract

Rigorous studies of treatment efficacy in schizoaffective disorder have been limited by the diagnosis' low diagnostic validity and reliability; thus, no current consensus treatment guidelines exist. Given this limitation, the authors recommend using available data from clinical trials in the mood disorder and psychosis literature to guide clinical practice. Antipsychotic treatment remains the mainstay of pharmacotherapy for illnesses on the schizophrenia spectrum, which includes schizoaffective disorder, both the depressive and bipolar subtypes. For patients with schizoaffective disorder, depressive type, treatment with combination antipsychotic and antidepressant therapy is a reasonable therapeutic starting point. For patients with schizoaffective disorder, bipolar type, antidepressant therapy may be less helpful. Instead, mood stabilizers may be an important component of treatment for people with schizoaffective disorder, bipolar type, particularly if there is irritability or aggression; some mood stabilizers, particularly lithium, may be effective in treating the depressive subtype as well. [ Psychiatr Ann . 2020;50(5):200–204.]