Treatment of Schizoaffective Disorders

Abstract

Studies that compare the treatment response of patients diagnosed as primary affective disorder or schizoaffective disorder are reviewed. Although relatively few controlled or uncontrolled studies of the chemotherapy of schizoaffective disorders have been conducted, available evidence suggests that: (1) lithium carbonate is effective in the initial treatment of both schizoaffective mania and mania; (2) antidepressants alone, neuroleptics alone, or their combination can be effective in the initial treatment of both schizoaffective depression and primary depression; and (3) prophylactic administration of lithium carbonate may reduce the frequency and duration of relapse in both schizoaffective manic and schizoaffective depressed patients. Thus, treatment studies indicate that the schizoaffective disorders are very similar to the primary affective disorders with regard to response to pharmacologic treatment. Evidence from this laboratory that schizoaffective manic patients respond more slowly than manic patients to lithium or neuroleptic treatment is presented.

Chronic Lithium Chloride Administration to Unanesthetized Rats Attenuates Brain Dopamine D2-Like Receptor-Initiated Signaling Via Arachidonic Acid

“…The finding that LiCl feeding upregulated baseline values of k* for AA in central auditory and visual areas of rat brain (see Results), which agrees with our previous observations (Basselin et al, 2005(Basselin et al, , 2003b, may be related to these clinical effects and to lithium's ability to reduce visual and auditory hallucinations in bipolar disorder patients (Goodnick and Meltzer, 1984;Potash et al, 2001).…”

Long-term Treatment of Schizoaffective Disorder: Review and Recommendations

“…Delva and Letemendia [19] reviewed lithium studies with regard to SAD, finding that the majority of studies found evidence for prophylactic effectiveness. The same conclusion was drawn by Goodnick and Meltzer [29] from 10 prophylaxis studies using lithium. Taylor [68], in his comprehensive overview, points out that most patients will benefit from lithium in the long-term treatment; however, Levinson and coworkers [41] came to the opposite conclusion.…”

“…In clinical practice, treatment decisions for SAD patients are often made by an analogy to schizophrenia or affective disorders. However, despite the bias described above, patients suffering from schizoaffective disorder often perform differently in longterm treatment studies when compared with patients with other diagnoses [29]. Thus, in long-term treatment studies including different disorders, it seems justified from empirical evidence to concentrate on the SAD cases.…”

Chronic Lithium Administration to Rats Selectively Modifies 5-HT2A/2C Receptor-Mediated Brain Signaling Via Arachidonic Acid

“…The elevations also may be related to the ability of toxic doses of lithium to cause auditory or visual hallucinations (Hambrecht and Kaumeier, 1993) or photophobia (Pridmore et al, 1996). On the other hand, lithium's blocking of the k* increments in response to DOI, a recognized hallucinogen (Sadzot et al, 1989), in visual and auditory areas and the substantia nigra and locus coeruleus, may relate to its ability to reduce hallucinations in bipolar disorder (Goodnick and Meltzer, 1984;Potash et al, 2001;Rosenthal et al, 1979).…”