How Schizoaffective Disorder Is Treated

Schizoaffective disorder is a lifelong condition that can be managed with medication and therapy. Medications include antipsychotics, mood stabilizers, and/or antidepressants.

If you or a loved one is living with schizoaffective disorder, it’s important to take medications as prescribed and to maintain consistent psychiatric care. This will help keep the symptoms as well controlled as possible. In some instances, hospitalization could be necessary for episodes of acutely worsening symptoms. 

Prescription Medications 

A number of prescription medications are used in the treatment of schizoaffective disorder. You might need to take one or more medications, depending on the specific effects of your condition.

Antipsychotics

Invega (paliperidone), an atypical second-generation antipsychotic, is the only medication with an FDA-approved indication for the treatment of schizoaffective disorder. This medication is available as an oral tablet that is taken daily and in a formulation that is taken as a monthly injection.

Oral Invega Tablet

For the treatment of schizoaffective disorder, the recommended dose is a 6 milligram (mg) extended-release tablet, taken in the morning, with or without food. The effective daily dose prescription can range between 3 and 12 mg once per day, with a maximum recommended dose of 12 mg/day. 

Side effects that can occur when oral Invega is used for treating schizoaffective disorder include extrapyramidal symptoms (a type of involuntary movement disorder), extreme tiredness, indigestion, constipation, weight gain, and flu-like symptoms.

Intramuscular Invega Injection

Invega is available as an injectable medication for the treatment of schizoaffective disorder. Your healthcare provider would give you your injection once per month. They will generally give you a trial of oral Invega to see how you tolerate it before starting treatment with the injection.

This medication is started at a dose of 234 mg, followed by 156 mg one week later. The injections are placed in your deltoid muscle, the large muscle of your shoulder.

After these first two doses, you would have monthly injections in your deltoid muscle or gluteal muscle (the large muscle of the hip and buttocks). Side effects of the injected form of this medication include extreme tiredness, dizziness, akathisia (urge to move), extrapyramidal symptoms, and weight gain.

Other Antipsychotics

Other antipsychotics that are indicated for the treatment of schizophrenia (a similar condition) are used off-label for the treatment of schizoaffective disorder, including Risperdal (risperidone) and Abilify (aripiprazole), which are atypical antipsychotics.

Mood Stabilizers 

Mood stabilizers are used to manage and prevent symptoms of mania and depression. These medications can be used for treatment of an acute episode of mania, such as during an episode requiring intervention or hospitalization, or on a regular schedule to prevent mood episodes. 

Lithium and valproate are commonly prescribed mood stabilizers used in the treatment of schizoaffective disorder.

Antidepressants 

Antidepressants can also have a role in the treatment of schizoaffective disorder when depressive symptoms are part of the condition. Commonly prescribed antidepressants in schizoaffective disorder include Zoloft (sertraline), Prozac (fluoxetine), and Wellbutrin (bupropion).

Therapies 

Meeting with a therapist has been found to be beneficial for the management of schizoaffective disorder. You should find a therapist you can trust and with whom you feel comfortable talking.

Different types of therapy that are part of schizoaffective disorder management include:

• Counseling: Your psychiatrist or a professional therapist will meet with you to talk about your symptoms and your feelings. You will also have guidance about how to manage emotions and other symptoms that can be distressing. 
• Social skills training: This type of therapy is based on a systematic way of modeling and practicing effective ways of communicating and interacting with others to optimize your ability to take care of day-to-day tasks and potentially maintain employment.
• Family therapy: If possible, bring a trusted family member or friend for family counseling sessions. You can get help with making a treatment plan, scheduling medication doses, and talking about your symptoms. These sessions can help you both understand what to expect from your condition and learn how to manage your communication with each other. 

One of the challenging aspects of living with schizoaffective disorder is a lack of insight. People who have this condition experience psychotic symptoms, which can involve delusions (false beliefs) and hallucinations (false sensations). It can be difficult to recognize that these psychotic symptoms are not real or that they represent an illness.

When your antipsychotic medication is working, you might gain insight and an understanding of your condition. During these times, you should talk to your psychiatrist and therapist about how to recognize signs that your condition could be getting worse—and when and how to get medical attention. 

Additional Interventions

Other interventions may be used.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a procedure administered under anesthesia. It involves careful administration of electrical currents to the scalp to induce a seizure and specific changes in brain activity. ECT is generally repeated at scheduled intervals for a duration of several weeks to months.

This type of treatment is used for managing severe or refractory depression or mania, particularly when depression is resistant to medication.

Genetic Counseling

Genetic counseling can be beneficial for people who have schizoaffective disorder. Learning about the genetic causes and risks of your condition has been found to provide a sense of control and empowerment for some people who are living with this disorder.

Hospitalization

Acute worsening of the symptoms of schizoaffective disorder can manifest with severe depression, self-harm, suicidality, disassociation from reality, and/or risky behavior due to mania.

An episode of worsening symptoms may require in-patient psychiatric care. During this time, you would be in a safe setting and you might have medication adjustments, as well as therapy, and possibly other interventions like ECT.

Lifestyle 

In general, maintaining a consistent schedule, having a healthy diet, and getting adequate sleep can help prevent illness, fatigue, and stress. These problems could provoke worsening symptoms of schizoaffective disorder. 

It also helps to have a few people you trust and can talk to. Make sure you have a plan in place so you can get medical attention promptly if your symptoms start to worsen. 

A Word From Verywell

Living with schizoaffective disorder is a challenge, although there is effective treatment to control the symptoms.

Effective treatment requires consistently taking medication, keeping up with your regular appointments with your psychiatrist and counselor, tracking your symptoms over time so you can get help when you need it, and having a social and family support structure.

If you need to be hospitalized for a worsening of your condition, rest assured that there is a light at the end of the tunnel and that your symptoms can be controlled so you can get back to living your best life after your acute phase of treatment is complete.