Current Pharmacotherapy in the Treatment of Schizoaffective Disorder
Pp. 53-74 (22)
Felix-Martin Werner and Rafael Coveñas
Abstract
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.
Affiliation:
Euro Akademie Pößneck Higher Vocational School for Elderly Care and Occupational Therapy Carl-Gustav-Vogel-Str. 13 07381 Pößneck Germany.