¹Medicine Institute, I.S. Turgenev Oryol State University, Orel; ²I.M. Sechenov First Moscow State Medical University, Moscow; ³Pirogov Russian National Research Medical University, Moscow, the Russian Federation
Corresponding author: Prof. Michael A. Nekrasov, PhD, ScD Department of psychiatry and neurology, Medicine Institute, I.S. Turgenev Oryol State University. Oryol, Russia, E-mail: firstname.lastname@example.org
Published: June 20, 2016. DOI: 10.21103/Article6(2)_OA5
Background: In most studies, patients with schizoaffective disorder (SAD) are often combined into one group along with schizophrenia patients or less commonly with those suffering from affective disorders, which makes it difficult to obtain data about the peculiarities of SAD treatment. Articles dedicated to SAD treatment in the interictal period are rare.
Methods and Results: The prospective cohort study was conducted from 2011 to 2015. The study involved 86 patients diagnosed with SAD according to ICD-10. Patients received neuroleptics (NLs) as antirelapse therapy for 2 years (NL therapy); then mood stabilizers (MSs) were added to the antirelapse treatment (NL+MS therapy). The results of this combined therapy with MSs were evaluated after 2 years of treatment. Our results suggest that the use of combination therapy that includes antipsychotics and MSs leads to maintenance of a higher quality remission. Remission becomes more prolonged and affective swings less pronounced, resulting in improved quality of life in SAD patients. Improving the quality of remission can be attributed to the following characteristics of the combined therapy: a) the use of lower doses of neuroleptics; b) a reduction in the frequency and severity of mood swings; and c) an increase in patient compliance.
Conclusion: The use of combined pharmacotherapy including antipsychotics and MSs produces a longer, high-quality remission. The inclusion of MSs in the scheme of treatment increases the patient adherence to a medication regimen. The use of MSs in combination therapy reduces affective fluctuations, thereby increasing the probability of maintaining remission with complete symptom relief.
- Padhy S, Hedge A. Schizoaffective Disorder: Evolution and Current Status of the Concept. Turk Psikiyatri Derg. 2015:26(2):131-7. [Article in Turkish]
- Pagel T, Franklin J, Baethge C. Schizoaffective disorder diagnosed according to different diagnostic criteria-systematic literature search and meta-analysis of key clinical characteristics and heterogeneity. J Affect Disord. 2014;156:111-8.
- Cosgrove VE, Suppes T. Informing DSM-5: biological boundaries between bipolar I disorder, schizoaffective disorder, and schizophrenia. BMC Med 2013;11:127.
- Arnold SJ, Ivleva EI, Gopal TA, Reddy AP, Jeon-Slaughter H, Sacco CB, et al. Hippocampal volume is reduced in schizophrenia and schizoaffective disorder but not in psychotic bipolar I disorder demonstrated by both manual tracing and automated parcellation (FreeSurfer). Schizophr Bull. 2015;41(1): 233-49.
- Amann BL, Canales-Rodríguez EJ, Madre M, Radua J, Monte G, Alonso-Lana S, et al. Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder. Acta Psychiatr Scand. 2016; 133(1): 23-33.
- Pagel T, Baldessarini RJ, Franklin J, Baethge C. Characteristics of patients diagnosed with schizoaffective disorder compared with schizophrenia and bipolar disorder. Bipolar Disord. 2013;15(3): 229-39.
- Pagel T, Baldessarini RJ, Franklin J, Baethge C. Heterogeneity of schizoaffective disorder compared with schizophrenia and bipolar disorder. Acta Psychiatr Scand. 2013;128(4): 238-50.
- Mancuso SG, Morgan VA, Mitchell PB, Berk M, Young A, Castle DJ A comparison of schizophrenia, schizoaffective disorder, and bipolar disorder: Results from the Second Australian national psychosis survey. J Affect Disord. 2015; 172:30-7.
- Alastair GC, Michael JO. Genetic Relationships Between Schizophrenia, Bipolar Disorder, and Schizoaffective Disorder. Schizophr Bull. 2014; 40(3):504–15.
- Glausier JR, Kimoto S, Fish KN, Lewis DA. Lower glutamic acid decarboxylase 65-kDa isoform messenger RNA and protein levels in the prefrontal cortex in schizoaffective disorder but not schizophrenia. Biol Psychiatry. 2015;77(2):167-76.
- Martín-Subero M, Berk L, Dodd S, Kamalesh V, Maes M, Kulkarni J, et al. Quality of life in bipolar and schizoaffective disorder-a naturalistic approach. Compr Psychiatry. 2014; 55(7):1540-5.
- Murru A, Hidalgo D, Bernardo M, Bobes J, Saiz-Ruiz J, Álamo C, Vieta E. Antipsychotic switching in schizoaffective disorder: A systematic review. World J Biol Psychiatry 2015; 9: 1-19.
- Pinna F, Deriu L, Lepori T, Maccioni R, Milia P, Sarritzu E, et al. Is it true remission? A study of remitted patients affected by schizophrenia and schizoaffective disorders. Psychiatry Res. 2013;210(3):739-44.
- Murru A, Pacchiarotti I, Amann BL, Nivoli AM, Vieta E, Colom F. Treatment adherence in bipolar I and schizoaffective disorder, bipolar type. J Affect Disord. 2013;151(3):1003-8.
- McDonnell DP, Landry J, Detke HC. Long-term safety and efficacy of olanzapine long-acting injection in patients with schizophrenia or schizoaffective disorder: a 6-year, multinational, single-arm, open-label study. Int Clin Psychopharmacol. 2014; 29(6):322–31
- Baethge C. Long-term treatment of schizoaffective disorder: review and recommendations. Pharmacopsychiatry. 2003; 36(2):45-56.
- Nimura S, Yamaguchi T, Ueda K, Kadokura K, Aiuchi T, Kato R, et al. Olanzapine promotes the accumulation of lipid droplets and the expression of multiple perilipins in human adipocytes. Biochem Biophys Res Commun. 2015;467(4):906-12.
- Pandey GN, Pandey SC, Ren X, Dwivedi Y, Janicak PG. Serotonin receptors in platelets of bipolar and schizoaffective patients: effect of lithium treatment. Psychopharmacology (Berl) 2003;170(2):115-23.
- Fu DJ, Turkoz I, Simonson RB, Walling DP, Schooler NR, Lindenmayer JP, et al. Paliperidone palmitate once-monthly reduces risk of relapse of psychotic, depressive, and manic symptoms and maintains functioning in a double-blind, randomized study of schizoaffective disorder. J Clin Psychiatry. 2015;76(3):253-62.
- Masand PS, Wang X, Gupta S, Schwartz TL, Virk S, Hameed A. Comparison of Risperidone and Olanzapine in Bipolar and Schizoaffective Disorders. Prim Care Companion J Clin Psychiatry. 2002; 4(2):70-73.
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Int J Biomed. 2016;6(2):119-123. © 2016 International Medical Research and Development Corporation. All rights reserved.