Psychiatr. pro Praxi, 2008; 9(2): 65-70

Schizoaffective disorder - monotherapy, or combined therapy?

MUDr. Ľubomíra Izáková PhD
Psychiatrická klinika FN a LF UK Bratislava

Schizoaffective disorder is a common and disabling mental illness. Unfortunately, the pharmacological treatment of this disorder has not been studied adequately. While several studies demonstrate the effectiveness of combined treatment for affective or negative symptoms in schizoaffective disorder, the use of atypical antipsychotics as monotherapy represents an important advance. The article reviewed therapeutic algorithms used in the treatment of schizoaffective disorder.

Keywords: schizoaffective disorder, monotherapy, combined therapy, antipsychotics, antidepressants

Published: April 15, 2008  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Izáková Ľ. Schizoaffective disorder - monotherapy, or combined therapy? Psychiatr. praxi. 2008;9(2):65-70.
Download citation

References

  1. Addington DE, Pantelis C, Dineen M et al. Efficacy and tolerability of ziprazidone versus risperidone in patients with acute exacerbation of schizophrenia or schizoaffective disorder: an 8 week, double blind, multicenter trial. J Clin Psychiatry 2004; 67(1): 1624-1633. Go to original source... Go to PubMed...
  2. Angst J, Dittrich A, Grof P. The course of endogenous affective psychosis and its modification by prophylactic treatment. Int Pharmacopsychiatry 1969; 2: 1-11. Go to original source...
  3. Azorin JM, Kaladjian A, Fakra E. Current issues on schizoaffective disorder. Encephale 2005; 31(3): 359-365. Go to original source... Go to PubMed...
  4. Banov MD, Zarate CA, Tohen M et al. Clozapine therapy in refractory affective disorders: polarity predicts response in long-term follow-up. J Clin Psychiatry 1994; 55: 295-300.
  5. Becker RE. Implications of efficacy of thiothixene and a chlorpromazine-imipramine combination for depression in schizophrenia. Am J Psychiatry 1983; 140: 208-211. Go to original source... Go to PubMed...
  6. Brockington IF, Kendall RE, Kellett JM et al. Trials of lithium, chlorpromazine and amitriptyline in schizoaffective patients. Br J Psychiatry 1978; 133: 162-168. Go to original source... Go to PubMed...
  7. Citrome L, Krakowski M, Greenberg WM et al. Antiaggressive effect of quetiapine in a patient with schizoaffective disorder. J Clin Psychiatry 2001, 62(11): 901. Go to original source... Go to PubMed...
  8. Conley RR, Mahmoud R. A randomized double-blind study of risperidone and olanzapine in the treatment of schizophrenia or schizoaffective disorder. Am J Psychiatry 2001; 158(5): 765-774. Go to original source... Go to PubMed...
  9. Diagnostic and Statistical Manual of Mental Disorders DSM-IV. 4th ed. APA: Washington DC 1994; 886 s.
  10. Dóci I, Kovářová M, Kovaničová M. Liečba schizoafektívnej poruchy na Psychiatrickej klinike v Košiciach v roku 2002. Psychiatrie 2003; Suppl. 2: 25-26.
  11. DSM III. Diagnostický a statistický manuál duševních poruch Americké psychiatrické společnosti, 3. revize (1980, překlad). Praha: Výzk. ústav psychiatrický (Zprávy č. 74) 1989; 332 s.
  12. Dufresne RL, Valentino D, Kaas DJ. Thioridazine improves affective symptoms in schizophrenic patients. Psychopharmacol Bull 1993; 29: 249-255. Go to PubMed...
  13. Dwight MM, Keck PE, Stanton SP et al. Antidepressant activity and mania associated with risperidone treatment of schizoaffective disorder [letter]. Lancet 1994; 344: 554-555. Go to original source... Go to PubMed...
  14. Ebert MH, Loosen PT, Nurcombe B. Current diagnosis and treatment in psychiatry. Lange Medical Books/McGraw Hill, USA 2000; 640 s.
  15. Flynn J, Grieger TA, Benedek DM. Pharmacologic treatment of hospitalized patients with schizoaffective disorder. Psychiatric Services 2002; 53(1): 94-96. Go to original source... Go to PubMed...
  16. Glick ID, Marder SR. Long term maintenance therapy with quetiapine versus haloperidol decaonate in patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 2005; 66(5): 638-641. Go to original source... Go to PubMed...
  17. Goff DC, Brotman AW, Waites M, McCormick S. Trial of fluoxetine added to neuroleptics for treatment-resistant schizophrenic patients. Am J Psychiatry 1990; 147: 492-494. Go to original source... Go to PubMed...
  18. Goff DC, Posever T, Her L, Simmons J et al. An exploratory haloperidol-controlled dose-finding study of ziprasidone in hospitalized patients with schizophrenia or schizoaffective disorder. J Clin Psychopharmacol 1998; 18(4): 296-304. Go to original source... Go to PubMed...
  19. Greil W, Ludwig-Mayerhofer W, Erazo N et al. Lithium vs carbamazepine in the maintenance treatment of schizoaffective disorder: a randomised study. Eur Arch Psychiatry Clin Neurosci 1997; 247(1): 42-50. Go to original source... Go to PubMed...
  20. Gunasekara NS, Spencer CM, Keating GM. Spotlight on ziprasidone in schizophrenia and schizoaffective disorder. CNS Drugs2002; 16(9): 645-652. Go to original source... Go to PubMed...
  21. Hillert A, Maier W, Wetzel H et al. Risperidone in the treatment of disorders with combined psychotic and depressive syndrome: a functional approach. Pharmacopsychiatry 1992; 25: 213-217. Go to original source... Go to PubMed...
  22. Hirschfeld RMA. Schizoaffective disorders and psychotic mania. Psychiatr Ann 1996; Suppl 7/26: 435-439. Go to original source...
  23. Hogarty GE, McEvoy JP, Ulrich RF et al. Pharmacotherapy of impaired affect in recovering schizophrenic patients. Arch Gen Psychiatry 1995; 52: 29-41. Go to original source... Go to PubMed...
  24. Izáková Ľ. Porovnanie účinnosti a bezpečnosti monoterapie a kombinovanej farmakoterapie schizoafektívnej poruchy (depresívny typ). Bratislava: Lundbeck 2007: 89 s.
  25. Janicak PG, Keck PE, Davis JM et al. A double blind, randomized, prospective evaluation of the efficacy and safety of risperidone versus haloperidol in the treatment of schizoaffective disorder. J Clin Psychopharmacol 2001; 21/4: 360-368. Go to original source... Go to PubMed...
  26. Johnson G, Gershon S, Burdock EI, Floyd A, Hekimian L. Comparative effects of lithium and chlorpromazine in the treatment of manic states. Br J Psychiatry 1971; 119: 267-276. Go to original source... Go to PubMed...
  27. Kane JM, Carson WH, Saha AR et al. Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2002; 63(9): 763-771. Go to original source... Go to PubMed...
  28. Kaplan HI, Sadock BJ, Grebb JA. Kaplan ans Sadock's synopsis of psychiatry: behavioral sciences, clinical psychiatry (7th ed.). Baltimore, USA: Williams and Wilkins 1994; 920 s.
  29. Kasanin J. The acute schizoaffective psychoses. Am J Psychiatry 1933; 13: 97-126. Go to original source...
  30. Keck PE Jr, Wilson DR, Strakowski SM et al. Clinical predictors of acute risperidone response in schizophrenia, schizoaffective disorder, and psychotic mood disorders. J Clin Psychiatry 1995; 56: 466-470.
  31. Keck PE Jr, Reeves KR, Harrigan EP. Ziprasidone Study Group.: Ziprasidone in the short-term treatment of patients with schizoaffective disorder: results from two double-blind, placebo-controlled, multicenter studies. J Clin Psychopharmacol 2001; 21(1): 27-35. Go to original source... Go to PubMed...
  32. Kinon BJ, Lipkovich I, Edwards SB et al. A 24-week randomized study of olanzapine versus ziprazidone in the treatment of schizophrenia or schizoaffective disorder in patients with prominent depressive symptoms. J Clin Psychopharmacol 2006a; 26(2): 157-162. Go to original source... Go to PubMed...
  33. Kinon BJ, Noordsy DL, Liu-Seifert H et al. Randomized, double blind 6-month comparison of olanzapine and quetiapine in patients with schizophrenia or schizoaffective disorder with prominent negative symptoms and poor functioning. J Clin Psychopharmacol 2006b; 26(5): 453-461. Go to original source... Go to PubMed...
  34. Kolibáš E et al. Špeciálna psychiatria. Bratislava: UK 1996; 228 s.
  35. Krakowski MI, Czobor P, Citrome L et al. Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry 2006; 63(6): 622-629. Go to original source... Go to PubMed...
  36. Kramer MS, Vogel H, DiJohnson C et al. Antidepressants in "depressed" schizophrenic inpatients: a controlled trial. Arch Gen Psychiatry 1989; 46: 922-928. Go to original source...
  37. Levinson DF, Umapathy C, Mohamado M. Treatment of schizoaffective disorder and schizophrenia with mood symptoms. Am J Psychiatry 1999; 156: 1138-1148. Go to original source... Go to PubMed...
  38. Linström E, Widerlöv B, Von Knorring L. The ICD-10 and DSM-IV diagnostic criteria and the prevalence of schizophrenia. Eur psychiatr 1997; 12(5): 217-223. Go to original source...
  39. Lipkovich I, Deberdt W, Buckley PF et al. Prediction of combined symptomatic and functional outcome in patients with schizophrenia and schizoaffective disorder. NeuroX 2006; 3(3): 410. Go to original source...
  40. Long PW. Schizoaffective disorder: Treatment. Internet Mental Health, 1990. Dostupné na internete: www.mentalhealth.com.
  41. Mattes JA, Nayak D. Lithium versus fluphenazine for prophylaxis in mainly schizophrenic schizoaffectiveness. Biol Psychiatry 1984; 19: 445-449.
  42. McElroy SL, Dessain EC, Pope HG Jr et al. Clozapine in the treatment of psychotic mood disorders, schizoaffective disorder and schizophrenia. J Clin Psychiatry 1991; 52: 411-414.
  43. Mezinárodní klasifikace nemocí. 10. revize. Duševní poruchy a poruchy chování. Praha: Psychiatrické centrum 1992; 282 s.
  44. Mishra A, Moore PB, Hobbs R. Does quetiapine have mood altering properties? J of Psychopharmacol 2004; 18: 281-284. Go to original source... Go to PubMed...
  45. Mohl A, Westlye K, Opjordsmoen S, Lex A et al. Long-lasting risperidone in stable patients with schizoaffective disorder. J of Psychopharmacol 2005; 19(5): 22-31. Go to original source... Go to PubMed...
  46. Müller-Siecheneder F, Müller MJ, Hillert A et al. Risperidone versus haloperidol and amitriptylin in the treatment of patients with a combined psychotic and depressive syndrome. J Clin Psychopharmacol 1998; 18: 111-120. Go to original source... Go to PubMed...
  47. Naber D, Hippius H. The European experience with clozapine. Hosp Community Psychiatry 1990; 41: 886-890. Go to original source... Go to PubMed...
  48. Potkin SG, Saha AR, Kujawa MJ et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry, 2003; 60(7): 681-690. Go to original source... Go to PubMed...
  49. Prien RF, Caffey EM, Klett CJ. Factors associated with treatment success in lithium carbonate prophylaxis. Arch Gen Psychiatry 1974; 31: 184-192. Go to original source... Go to PubMed...
  50. Prusoff BA, Williams DH, Weismann MM, Astrachan BM. Treatment of secondary depression in schizophrenia: a double-blind, placebo-controlled study of amitriptyline added to perphenazine. Arch Gen Psychiatry 1979; 136: 569-575. Go to original source... Go to PubMed...
  51. Sajatovic M, Brescan DW, Perez DE et al. Quetiapine alone and added to a stabilizer for serious mood disorders. J Clin Psychiatry 2001; 62(9): 728-732. Go to original source... Go to PubMed...
  52. Schooler N, Rabinowitz J, Davidson M et al. Early psychosis global working group. Risperidone and haloperidol in the first-episode psychosis: a long-term randomized trial. Am J Psychiatry 2005; 162: 947-953. Go to original source... Go to PubMed...
  53. Simpson GM, Glick ID, Weiden PJ, Romano SJ, Siu CO. Randomized double-blind multicenter comparison of the efficacy and tolerability of ziprazidone and olanzapine in acutely ill patients with schizophrenia or schizoaffective disorder. Am J Psychiatry 2004; 161(10): 1837-1847. Go to original source... Go to PubMed...
  54. Siris SG, Morgan V, Fagerstrom R et al. Adjunctive imipramine in the treatment of postpsychotic depression. Arch Gen Psychiatry 1987; 44: 533-539. Go to original source... Go to PubMed...
  55. Swainston Harrison T, Perry CM. Aripiprazole: a review of its use in schizophrenia and schizoaffective disorder. Drugs 2004; 64(15): 1715-1736. Go to original source... Go to PubMed...
  56. Tohen M, Sanger TM, Tollefson GD, McElroy SL. Olanzapine vs haloperidol in the treatment of schizoaffective bipolar patients. Presented at second intern conference on bipolar disorder, USA 2000.
  57. Tollefson GD, Sanger TM, Lu Y, Thieme ME. Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. Arch Gen Psychiatry 1998; 55(11): 250-258. Go to original source... Go to PubMed...
  58. Tran PV, Tollefson GD, Sanger TM et al. Olanzapine versus haloperidol in the treatment of schizoaffective disorder. Acute and long-term therapy. Br J Psychiatry 1999; 174: 15-22. Go to original source... Go to PubMed...
  59. Vieta E, Goikolea JM, Corbella B et al. (Group for the Study of Risperidone in Affective Disorders [GSRAD]) Risperidone safety and efficacy in the treatment of bipolar and schizoaffective disorder: results from a 6-month, multicenter, open study. Erratum. J Clin Psychiatry 2002; 63(1): 79.
  60. Vojteková Ľ, Halaris A, Pospíšil R. Monoterapia versus kombinovaná liečba akútnej fázy depresívneho typu schizoafektívnej poruchy. Psychiat pro Praxi 2002; 4: 25-29.
  61. Volavka J, Czobor P, Citrome L et al. Efficacy of aripiprazole against hostility in schizophrenia and schizoaffective disorder: Data from 5 double-blind studies. J Clin Psychiatry 2005; 66(11): 1362-1366. Go to original source... Go to PubMed...




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.